You recently recovered from COVID-19, but now you have a rash and fever. Could these symptoms be connected to your infection? Although COVID-19 mainly affects the lungs, it’s also known for having unusual symptoms involving other parts of the body — including signs of blood vessel inflammation, called vasculitis.
Vasculitis seems to be a rare complication of COVID-19, but it can lead to several symptoms. This article will cover four signs of vasculitis to look out for and when to talk to your doctor.
Vasculitis — also known as angiitis or arteritis — is a condition that causes inflammation (swelling) of your blood vessel walls. Although it can develop on its own, vasculitis is typically triggered by an infection, trauma, or an overreaction of your body’s immune system.
Unfortunately, the link between vasculitis and COVID-19 isn’t well studied. Doctors and researchers are still learning how these two conditions may be connected. Few studies have reported on vasculitis symptoms in relation to COVID-19 infection, so information is relatively limited.
Several forms of vasculitis can affect different blood vessels throughout your body. However, four types seem to affect most people after COVID-19 infection — immunoglobulin A (IgA) vasculitis, leukocytoclastic vasculitis (LCV), urticarial vasculitis, and Kawasaki-like disease.
Here are details regarding four symptoms of vasculitis that may be seen during or after a COVID-19 infection.
If red or purple rashes start to appear on your legs and feet after a COVID-19 infection, they may indicate vasculitis. Both LCV and IgA vasculitis can develop after infections and may cause similar symptoms, like red or purple rashes on the lower half of your body.
LCV develops when deposits of immune complexes (molecules that are part of the immune response) and immune proteins damage the small blood vessels. This creates inflammation and makes the blood vessels leaky, leading to raised rashes or skin lesions on your legs. Known as palpable purpura, these lesions can appear in different spots on their own or be grouped together. They may also be painful or itchy.
IgA vasculitis — sometimes known as Henoch-Schönlein purpura — can develop after an immune response, like your immune system fighting the SARS-CoV-2 virus. This process creates specialized proteins known as immunoglobulins (antibodies) that tag infected cells to be destroyed. Some people are genetically prone to IgA vasculitis.
Sometimes, antibodies clump together and form immune complexes that become stuck in the small blood vessels underneath your skin. Like LCV, a common symptom of IgA vasculitis is a raised red or purple rash that looks like small dots or bruises. These rashes are more common on the legs and buttocks, but they can also be found on the face, arms, and torso.
Have you developed itchy, raised, red areas that look and feel like hives? This is a sign of urticarial vasculitis, a rare type of vasculitis also triggered by infections and autoimmune diseases. Anyone can develop urticarial vasculitis, but it usually occurs between ages 30 and 40 and affects about twice as many women as men, according to the Vasculitis Foundation.
Small case reports of people with COVID-19, both with and without symptoms of the virus, have noted they experienced urticarial vasculitis. Interestingly, some people reported developing this condition a few weeks after recovering from their infection.
The first sign of urticarial vasculitis is itchy or painful hives or raised skin lesions (wheals) that can last 24 hours or more. The lesions are discolored around the outside with white centers, sometimes with tiny red or purple spots from leaky blood vessels. After the lesions go away, they may leave darkened, bruiselike patches of skin.
When your body fights an infection, it creates extra inflammation to activate your immune system. This inflammation can start attacking your body’s healthy tissues and leave you feeling achy and tired when you’re sick.
Inflammation from your COVID-19 infection can also cause systemic (bodywide) symptoms of vasculitis. Examples include:
These symptoms can sometimes occur with LCV, IgA vasculitis, or urticarial vasculitis. If you develop a fever or joint pain along with rashes or hives, talk to your doctor.
If your child recently had a COVID-19 infection and now has a fever, swollen lymph nodes, or rashes, they may have a condition similar to Kawasaki disease. This form of vasculitis typically affects children under age 5, according to Mayo Clinic. Kawasaki disease rarely develops in adults.
Kawasaki disease is caused by inflammation and swelling of small and medium blood vessels throughout the body. It can also affect the blood vessels that bring blood to the heart.
Since there’s a chance that Kawasaki disease can lead to long-term heart problems, it’s important to get treatment as soon as possible. Be sure you’re aware of the symptoms of Kawasaki disease, including:
Studies report that children and teenagers with COVID-19 can develop symptoms that look very similar to Kawasaki disease. Researchers have dubbed this condition “Kawasaki-like disease.” Some case reports have noted that adults can have a similar reaction. There currently isn’t a test to diagnose Kawasaki disease, making it difficult to link this condition with COVID-19 infection.
If you’re experiencing any new signs of a COVID-19 infection, long COVID, or vasculitis, talk to your health care provider. They can confirm a diagnosis and start you or your child on an appropriate treatment plan. Depending on your type of vasculitis, you may need different medications.
For example, IgA vasculitis typically doesn’t require treatment and tends to go away on its own within a few weeks to months. If you’re experiencing joint pain, fever, or abdominal pain, your doctor may prescribe medications to relieve these types of symptoms.
If you have LCV, your doctor may recommend resting and elevating your legs, along with taking an antihistamine medication. If your symptoms don’t improve or if they become worse, your doctor may prescribe a corticosteroid (for example, prednisone) to help reduce inflammation.
Kawasaki-like disease may be treated with intravenous immune proteins and aspirin to lower your child’s inflammation levels.
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