What are COVID toes?
In a recent post on Podiatry Today, authors Nicholas A. Campitelli, DPM, FACFAS and Kelly Kubiak DPM note that there have been reports from all over the world of COVID-19 patients experiencing a broad range of external symptoms on their toes, including both general discoloration as well as open lesions.
One broadly supported hypothesis is that these skin presentations are a result of vascular blockages. We’ve been seeing reports of hypercoagulation, or lots of tiny blood clots, in many patients. These little clots could be blocking very small blood vessels, leaving toes with insufficient blood and oxygen supply. That could certainly explain why they can look like other conditions that result in poor circulation in the toes, such as Reynaud’s. Another hypothesis is that the virus is attaching to the small vessels, as it is known to do in the lungs. There is evidence that it is also doing this in the heart and kidneys, where we are seeing damage occurring as well.
Many of the patients being observed with toe, and other skin symptoms, lack the classic respiratory symptoms we have been told to look for. Medical professionals are seeing young, otherwise healthy patients with otherwise unexplained rashes and lesions. Anecdotally, many of the children with these symptoms are living with adults who are experiencing more classic COVID-19 symptoms or who have been diagnosed with the virus.
These external symptoms have been reported to occur with or without respiratory or flu-like symptoms, in young and old patients. If you notice your toes turning red, purple, or blue, please seek medical attention. If you develop blisters or other sores, or if your toes are painful, please seek medical attention. As always, if you notice any sudden change in your toes (and I hope you are looking at them!), you should contact your doctor right away. Consider asking for a COVID-19 test, as they are becoming easier to access in the Seattle area, and you could be contributing to community knowledge. Take photos starting when you notice any changes, so you can keep track over time. For examples of what this can look like, click through to the article.
Many healthcare providers are offering online consultations, so you can be sure to go to the right place if you have to visit a clinic. If you are experiencing, or recently had, any of the established COVID-19 symptoms, be sure to mention it. That said, it’s hard to imagine your doctor wouldn’t ask!
As it stands, COVID toes seem to be a likely symptom of COVID-19, but there is not yet sufficient documentation to verify it.