COVID toes is really a phenomenon which started to be described in Spain and Italy at the beginning of wintertime within the first wave of the novel coronavirus epidemic in 2020. The reports were seeing a quite high incidence of chilblains in the feet in individuals with COVID-19. The news media latched on to these stories and lots of consideration was given to them. Plenty of fascination continues to be produced from the general public and health professionals in the entire phenomenon of these COVID toes.
There are a variety of pathophysiological processes regarding COVID-19, for example problems with the blood vessels, the cytokine storm and inflammatory processes which could change the blood flow in the toes that predispose the foot or toes to having chilblains. Chilblains really are a poor reaction of the microcirculation to alterations in temperature. When the small arteries do not react adequately, waste products gather in the skin bringing about an inflammatory response that becomes the chilblain. It is really possible to observe how COVID-19 can increase the chance of having a chilblain. Many early on histological analyses from biopsies in the chilblains of individuals with COVID-19 did report that there had been components of the problem within the tissues. However, different research has showed that there weren’t any, therefore it has started to become fairly complicated about what the link between the 2 entities actually are.
The problem is that with the passage of time and additional investigation we have an increasing number of reviews that there is no link between chilblains and COVID-19 and the high incidence is only a coincidence. There's one review within the Nordic region that there has been not any increase in the incidence of chilblains there. Some other current studies by way of biopsies in addition to post-mortem autopsy have found no COVID-19 factors in the chilblains. There is conjecture that the presumed increase in the incidence in a few nations is a problem with the lifestyle modifications because of the lockdown through the pandemic and that they aren't in reality part of the pathophysiological response of the COVID-19. These types of changes in lifestyle through the lockdown can consist of becoming much more sedentary, probably the less wearing of shoes, becoming more exposed to air-conditioning along with the constant warmth indoors. These kinds of changes in lifestyle during lockdown might have been greater in countries such as Italy and Spain and the alterations could not have been so great in the Nordic nations. In Nordic countries they may just be much better at handling the issues about temperature fluctuations which are thought to be a risk factor in chilblains. This can certainly simply be the cause of the different frequency in the above areas.
An episode of the popular podiatry Facebook live, PodChatLive was on this very theme. The livestream hosts chatted with a podiatrist from South Africa, Nadia Dembskey who is about to commence a PhD on the subject. All of the aforementioned problems had been discussed, and they still have not really been reconciled. Given all of the wavering publications as well as the contradicting ideas that there are on COVID toes, it might be a while before the science gets to handle this.