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Painful & discolored: Akron Children's Hospital reports about 20 cases of 'COVID Toes'

Posted at 6:36 PM, Jul 20, 2020
and last updated 2020-07-20 21:57:41-04

AKRON, Ohio — The strange feeling in the toes of 14-year-old Gwen King, of Kent, started last March around the time the pandemic was hitting Ohio.

"They were very hot and swollen and I couldn't feel them, but at the same time, they like stung," she said.

Back then, access to COVID-19 testing was difficult, especially for younger, healthier people.

Gwen's father, Casey King, said there was so much conflicting information circulating, but wondered if the sudden and unusual pain in his daughter's toes could be a symptom of the virus.

14-year-old Gwen King, of Kent.

"The symptoms seem to be a moving target and there seems to be so many potential symptoms," he said. "It was daunting. We weren't real sure what to make of it."

Several weeks after the teen began experiencing the pain, tests were conducted that ruled out diabetes and autoimmune disorders such as lupus.

The King family suspects Gwen may have experienced a case of COVID Toes, a condition they first read about in a May New York Times Article.

The condition that often includes painful, swollen and discolored toes, referred to as chilblains, has long been recognized as a complication of certain infectious diseases and rheumatologic conditions, according to Akron Children's Hospital.

The hospital has seen about 20 cases of teens or young adults suspected of having COVID Toes since the pandemic started.

Pediatric rheumatologist Dr. Steven Spalding said chilblains are typically thermal injuries seen in the colder months.

"We're seeing more of that now during the pandemic than we would normally expect to see. Usually, we would see it in January and February. Now, we're seeing it in April, May and June," Spalding said.

Spalding said recent research from the British Journal of Dermatology showed the presence of the coronavirus in blood vessels of toe and fingers.

Interestingly, Spalding said many patients test negative for COVID-19 through nasal swabs, but it's believed the same virus is attacking the blood vessels and causing the color change in toes.

"You have it. You have an infection, but it's not in your nose. It's not causing the normal respiratory findings that we hear so much about. This is a different form of COVID that we're now recognizing."

Spalding said cases of COVID Toes should not be alarming and usually go away in one to three months. However, he added the "jury is still out" on whether patients with the toe condition are contagious.

"If we see it in the toes but we don't see it in the nose, we're not quite sure whether a person is not contagious or they are contagious," Spalding said.

Gwen said her experience was scary, but several months later, her toes are doing better, for the most part.

"Every once in a while, they'll get a little swollen again, but that's about it," she said.

Dr. Spalding offered advice if parents suspect something seems odds about the toes of their children.

"If they see this, they should see their primary care physician and make sure there's no other symptoms of COVID going on at that time."