The chief symptoms of Covid-19 are fever, cough, fatigue, and a lack of sense of taste and smell. Signs of Covid-19 in the skin have been identified too. But there is a different part of the body where the virus seems to have an influence: the fingernails.
After a Covid-19 infection, for a small number of patients, the fingernails seem discolored or distorted several weeks following a phenomenon that’s been named “Covid nails”.One sign is a red half-moon pattern that creates a convex ring over the white patch at the bottom of fingernails. This appears to present earlier than other Covid-related nail complaints, with patients regarding it less than two weeks after being diagnosed. Various causes have been recorded but not many.
Red half-moon nail patterns similar to this are usually rare and previously haven’t been noticed so adjacent to the nail base. So having this pattern seem like this could solely be evidence of a Covid-19 infection. The mechanism holding this half-moon patterning continues unclear. A potential reason could be blood vessel harm correlated with the virus itself. It may be due to the immune response climbed against the virus creating mini blood clots and blemish. Importantly, these signs don’t seem to be anything to bother about, as patients are otherwise asymptomatic although it is unclear how long they remain for, having endured from between one week to over four weeks in the cases recorded.
A few patients have also discovered new horizontal sections in the roots of the nails of their fingers and toes, which are known as Beau’s lines. These lead to appear four weeks or more after a Covid-19 disease. Beau’s lines happen when there is a short break in nail growth because of physical stress on the body, such as contamination, malnutrition, or side-effects of medications such as chemotherapy drugs. While it’s plausible that they’re created by Covid-19, they’re not an exclusive sign of the disease.
As nails grow between 2mm and 5mm a month on average, Beau’s lines manage to become obvious four to five weeks after the physical stress occurs as the nail grows, the indentation is exposed. The timing of the stressful situation can be hence evaluated by looking at how far Beau’s lines are from the nail base. There’s no definite treatment for Beau’s lines, as they tend to eventually grow out if the underlying disease has settled. Currently, the available data implies that there’s no connection between the rigor of Covid-19 infection and the nature or extent of nail alterations.
The above mentioned are the two more general Covid-related nail complaints, but researchers have shown some other unusual circumstances as well. One female patient’s nails slackened from the nail base and ultimately fell out, three months after her disease. This aspect is known as onychomadesis and is believed to occur for related reasons to Beau’s lines emerging. This patient didn’t obtain treatment for these variations as new healthy nails could be noticed growing underneath those that separated, showing that the problem was starting to resolve itself. Another patient, 112 days after testing positive, observed orange discoloration to nail tips. No medication was administered and the discoloration had still not resolved after a month. The underlying mechanism behind this is unexplained.
And in a third case, a patient had straight white lines develop on the nails that don’t fade with pressure. These are identified as Mees’ lines or transverse leukonychia. They emerged 45 days after testing positive for Covid-19. These manage to resolve with nail growth and do not need treatment. Mees’ lines are assumed to be created by the abnormal production of proteins in the nail bed because of systemic ailments. Although these three conditions followed a Covid-19 epidemic, because we only have restricted patients to seem at in each case, it isn’t possible to say yet whether they were generated by the disease. All three may be irrelative to the ailment.
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Certainly, even with Beau’s lines and red half-moon pattern, there is still a long way to confirm a definite link between these changes and Covid-19 as well as the mechanisms behind them. For all these conditions, we’ll require many more cases to be reported before we can state with certainty that there’s a connection. Moreover, even if there is a causative connection, it’s relevant to recognize that not all patients with Covid-19 will have these nail ailments. And some of these irregularities may not inevitably suggest someone has had Covid-19. At best, we should consider these as possible indicators of prior infection and not absolute proof.
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