Around April 2020 when the COVID-19 pandemic was at its peak in Europe there were increasing reports of what appeared to be chilblains on the feet appearing with a very high frequency in those infected with the novel coronavirus. The mass media caught on to these reports and a lot of attention has been paid to these so-called COVID toes.
Chilblains are reasonably common in the colder climates anyway, and it was not clear what the significance of them appearing so often in those with COVID-19 was as it was winter in the northern hemisphere when these media reports started to appear. Since those initial reports, there have now been a number of published studies on COVID toes and chilblains. That has not necessarily led to an increased understanding of the problem with mixed results and commentary in the medical literature. The reason for this is that it could be due to one (or both) of two possible explanations:
- the chilblains could be part of the pathophysiology of the coronavirus infection. Chilblains are well known as a problem with the small blood vessels and how they react to the cold, so the inflammatory process of the infection could affect the way the blood vessels react, causing the chilblain. COVID-19 has been well documented as affecting the vascular system, so the chilblains could be due to this mechanism
- the higher incidence of the chilblains may actually not be directly related to the COVID-19, but may be due to lifestyle changes that happened during the lockdown associated with the pandemic and it was those lifestyle changes that predisposed to the chilblains. Spending more time in centrally heated houses rather than outdoors in the colder climates could be a factor in the increased prevalence of chilblains.
While it’s not clear if its both or either of the above, COVID toes are definitely a thing. If you have chilblains and you do not normally get them or if you have them and there is something out of the ordinary with them, then it might pay to get that investigated further. Regardless of the cause of the chilblains, the management is the same and the feet need to be protected from the cold and the application of creams to stimulate the circulation in the small blood vessels is important.
