medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-020medsovet-7394Research ArticleТРИХОЛОГИЯTRICHOLOGYСвязь выпадения волос и коронавирусной инфекции COVID-19 – факты и гипотезыThe association of hair loss and coronavirus infection COVID-19 – facts and hypotheseshttps://orcid.org/0000-0001-8584-615XСмирноваИ. О.SmirnovaI. O.

Смирнова Ирина Олеговна, д.м.н., профессор кафедры инфекционных болезней, эпидемиологии и дерматовенерологии; врач-дерматовенеролог

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

192102, Россия, Санкт-Петербург, наб. реки Волковки, д. 3 

Irina O. Smirnova, Dr. Sci. (Med.), Professor of the Department of Contagious Diseases, Epidemiology and Dermatovenereology; STD and skin specialist

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia

3, Emb. of the Volkovka River, St Petersburg, 192102, Russia 

driosmirnova@yandex.ruhttps://orcid.org/0000-0002-9077-2594МедецкаяО. М.MedetskayaO. M.

 Медецкая Ольга Михайловна, аспирант кафедры инфекционных болезней, эпидемиологии и дерматовенерологии; врач-дерматовенеролог 

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

192102, Россия, Санкт-Петербург, наб. реки Волковки, д. 3 

Olga M. Medetskaya, Postgraduate Student of the Department of Contagious Diseases, Epidemiology and Dermatovenereology; STD and skin specialist

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia;

3, Emb. of the Volkovka River, St Petersburg, 192102, Russia 

drolgamed@rambler.ruhttps://orcid.org/0000-0002-6489-4555ПетуноваЯ. Г.PetunovaYa. G.

Петунова Янина Георгиевна, к.м.н., доцент кафедры инфекционных болезней, эпидемиологии и дерматовенерологии; врач-дерматовенеролог 

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

192102, Россия, Санкт-Петербург, наб. реки Волковки, д. 3 

Yanina G. Petunova, Cand. Sci. (Med.), Associate Professor of the Department of Contagious Diseases, Epidemiology and Dermatovenereology; STD and skin specialist

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia

3, Emb. of the Volkovka River, St Petersburg, 192102, Russia 

yaninapetunova@yandex.ruhttps://orcid.org/0000-0003-4699-1746ПташниковаП. Д.PtashnikovaP. D.

 Пташникова Полина Дмитриевна, студент

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

 Polina D. Ptashnikova, Student

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia 

enternita7@yandex.ruhttps://orcid.org/0000-0002-8138-1639ШинН. В.ShinN. V.

 Шин Наталья Валентиновна, к.м.н., доцент кафедры инфекционных болезней, эпидемиологии и дерматовенерологии  

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

Natalia V. Shin, Cand. Sci. (Med.), Associate Professor of the Department of Contagious Diseases, Epidemiology and Dermatovenereology

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia 

shinataly@mail.ruhttps://orcid.org/0000-0002-8007-8945ЖелонкинаА. О.ZhelonkinaA. O.

 Желонкина Ангелина Олеговна, аспирант кафедры инфекционных болезней, эпидемиологии и дерматовенерологии 

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

Angelina O. Zhelonkina, Рostgraduate Student of the Department of Contagious Diseases, Epidemiology and Dermatovenereology

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia 

lina.zhelonkina@gmail.comhttps://orcid.org/0000-0001-9013-3197ЖелонкинА. Р.ZhelonkinA. R.

 Желонкин Антон Романович, аспирант кафедры инфекционных болезней, эпидемиологии и дерматовенерологии 

199034, Россия, Санкт-Петербург, Университетская наб., д. 7–9 

Anton R. Zhelonkin, Рostgraduate Student of the Department of Contagious Diseases, Epidemiology and Dermatovenereology

7–9, Universitetskaya Emb., St Petersburg, 199034, Russia 

good.tony@yandex.ruhttps://orcid.org/0000-0002-1045-9689СмирноваО. Н.SmirnovaO. N.

Смирнова Ольга Николаевна, к.м.н., доцент кафедры дерматовенерологии 

195067, Россия, Санкт-Петербург, Пискаревский проспект, д. 47 

 Olga N. Smirnova, Cand. Sci. (Med.), Associate Professor of the Department of Dermatovenereology

47, Piskarevskiy Ave., St Petersburg, 195067, Russia 

dronsmirnova@mail.comСанкт-Петербургский государственный университет; Городской кожно-венерологический диспансерРоссияSt Petersburg State University; City Dermatovenerological DispensaryRussian FederationСанкт-Петербургский государственный университетРоссияSt Petersburg State UniversityRussian FederationСеверо-Западный государственный медицинский университет имени И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation2023160320230298104Copyright © Смирнова И.О., Медецкая О.М., Петунова Я.Г., Пташникова П.Д., Шин Н.В., Желонкина А.О., Желонкин А.Р., Смирнова О.Н., 20232023Смирнова И.О., Медецкая О.М., Петунова Я.Г., Пташникова П.Д., Шин Н.В., Желонкина А.О., Желонкин А.Р., Смирнова О.Н.Smirnova I.O., Medetskaya O.M., Petunova Y.G., Ptashnikova P.D., Shin N.V., Zhelonkina A.O., Zhelonkin A.R., Smirnova O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7394

Основными проявлениями COVID-19 прежде всего является интерстициальная пневмония и дыхательная недостаточность. Не менее чем у 20% больных возникают вариабельные высыпания на коже, которые пытаются трактовать как маркеры и предикторы особенностей течения коронавирусной инфекции. Помимо этого, характерным проявлением COVID-19 является выпадение волос, а сально-волосяные фолликулы рассматриваются как мишень для SARS-CoV-2. Наиболее частыми вариантами алопеции у пациентов с перенесенной новой коронавирусной инфекцией или вакцинацией от нее являются острая телогеновая, гнездная, а также андрогенетическая алопеция. В обзоре приведены сведения о наиболее часто встречающихся вариантах выпадения волос у пациентов с инфекцией, вызванной SARS-CoV-2, особенностях их проявлений, а также возможных механизмах развития. Острое телогеновое выпадение волос является самым частым вариантом индуцированной SARS-CoV-2 алопеции, характерно для пациентов с подострым течением COVID-19 и может сочетаться с триходинией, аносмией и агевзией, являющимися маркерами поражения нервной системы. С учетом вариабельности времени начала заболевания после перенесенной инфекции можно предположить неоднородный патогенез алопеции. Гнездная алопеция после перенесенного COVID-19 нередко представляет собой рецидив заболевания, ее тяжесть и частота не коррелируют с тяжестью инфекционного заболевания, а преобладание у женщин указывает на значение гормональных факторов в ее развитии. Андрогенетическая алопеция может быть предиктором высокого риска заражения, тяжелого течения и рецидивов COVID-19. Первые два варианта алопеций могут быть ассоциированы с вакцинацией по поводу COVID-19, а последняя – предиктором недостаточного иммунного ответа на введение вакцины. Механизмы повреждающего действия SARS-CoV-2 на волосяные фолликулы расшифрованы не полностью и, вероятнее всего, являются комплексными, с различными ведущими звеньями при разных видах выпадения волос. Расшифровка этих механизмов может создать предпосылки для понимания механизмов повреждения других тканей и органов COVID-19.

The main manifestations of COVID-19 are primarily interstitial pneumonia and respiratory failure. No less than 20% of patients have variable skin rashes, which try to be interpreted as markers and predictors of the peculiarities of the course of coronavirus infection. In addition, hair loss is a characteristic manifestation of COVID-19, and the salivary follicles are regarded as a target for SARS-CoV-2. The most common variants of alopecia in patients with a new coronavirus infection or vaccine-induced alopecia are acute telogenic, nondescript, and androgenetic alopecia. This review provides information on the most common variants of hair loss in patients with SARS-CoV-2 infection, the features of their manifestations, and possible mechanisms of development. Acute telogenic hair loss is the most common variant of SARS-CoV-2-induced alopecia, is characteristic of patients with subacute course of COVID-19 and can be combined with trichodynia, anosmia and aguvia, which are markers of nervous syste damage. Given the variability in the time of onset after infection, a heterogeneous pathogenesis of alopecia can be assumed. Nested alopecia after COVID-19 is often a relapse of the disease, its severity and frequency do not correlate with the severity of the infectious disease, and its prevalence in women indicates the importance of hormonal factors in its development. Androgenetic alopecia may be a predictor of high risk of infection, severe course, and recurrence of COVID-19. The first two variants of alopecia may be associated with COVID-19 vaccination, and the latter is a predictor of inadequate immune response to vaccine administration. The mechanisms of the damaging effects of SARS-CoV-2 on hair follicles have not been fully deciphered and are most likely complex, with different leading links in different types of hair loss. Deciphering these mechanisms may provide prerequisites for understanding the mechanisms of COVID-19 damage to other tissues and organs.

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The authors declare that there are no conflicts of interest present.