key: cord-1008347-fti7u5do
authors: Maia, Célia Márcia Fernandes; Marques, Nelson Pereira; de Lucena, Edson Hilan Gomes; de Rezende, Luiz Fernando; Martelli, Daniella R. Barbosa; Martelli-Júnior, Hercílio
title: Increase in the number of Herpes Zoster cases in Brazil related to the COVID-19 pandemic
date: 2021-02-11
journal: Int J Infect Dis
DOI: 10.1016/j.ijid.2021.02.033
sha: 6a527daf32b662a515bfe1e9527d5af8809b068b
doc_id: 1008347
cord_uid: fti7u5do

Coronavirus 2019 (COVID-19), caused by the pathogen SARS-CoV-2, was declared a pandemic in March 2020. Recently, studies have discussed reports of patients infected with COVID-19 associated with vesicular manifestations of Herpes Zoster. The objective of this study was to compare the data from the Unified Health System (SUS), on the number of diagnoses of Herpes Zoster from March to September 2017 to 2019, with the same period of 2020, in the five Brazilian regions (North, Northeast, Southeast, South and Midwest). The analyzed data were extracted from the public database (DATASUS) of the Ministry of Health of Brazil. The data showed an increase in the number of Herpes Zoster diagnoses over the years, and the negative impact from the COVID-19 disease, revealing an increase corresponding to an average of over extra 10.7 cases per million of inhabitants during the COVID-19 pandemic in all Brazilian Regions. Therefore, although the association between HZ and COVID-19 is not well stablished, we observed in this study an increase in HZ cases during the COVID -19 pandemic, which suggests a correlation between these diseases.

Coronavirus 2019 , caused by the pathogen SARS-CoV-2, was declared a pandemic in March 2020. Recently, studies have discussed reports of patients infected with COVID-19 associated with vesicular manifestations of Herpes Zoster. The objective of this study was to compare the data from the Unified Health System (SUS), on the number of diagnoses of Herpes Zoster from March to September 2017 to 2019, with the same period of 2020, in the five Brazilian regions (North, Northeast, Southeast, South and Midwest) . The analyzed data were extracted from the public database (DATASUS) of the Ministry of Health of Brazil. The data showed an increase in the number of Herpes Zoster diagnoses over the years, and the negative impact from the COVID-19 disease, revealing an increase corresponding to an average of over extra 10.7 cases per million of inhabitants during the COVID-19 pandemic in all Brazilian Regions. Therefore, although the association between HZ and COVID-19 is not well stablished, we observed in this study an increase in HZ cases during the COVID -19 pandemic, which suggests a correlation between these diseases.

Keywords: COVID-19; Herpes Zoster; Pandemics; J o u r n a l P r e -p r o o f pandemic by the World Health Organization (WHO) in March 2020 (Recalcati, 2020) . Studies have discussed reports of patients infected with COVID-19 associated with vesicular manifestations of Herpes Zoster (HZ) Llamas-Velasco et al., 2020; Marzano et al., 2020; Ortega-Quijano et al., 2020; Recalcati, 2020) . Recalcati (2020) reported for the first time the involvement of skin manifestations with the COVID-19 infection.

Varicella and Herpes zoster are diseases caused by the varicella-zoster virus (VZV) (Elsaie and Nada, 2020) , which in its initial phase causes chickenpox ("Chickenpox"). This virus remains latent within the dorsal root of the trigeminal ganglion, and after its reactivation, it manifests itself as HZ (Elsaie and Nada, 2020) . The objective of this study was to compare the data from the Unified Health System (SUS) on the number of diagnoses of Herpes Zoster from March to September 2017 to 2019, with the same period of 2020, in the five Brazilian regions (North, Northeast, Southeast, South and Midwest).

The analyzed data were extracted from the public database (DATASUS) (http://tabnet.datasus.gov.br/cgi/tabcgi.exe?sia/cnv/qauf.def) of the Ministry of Health of Brazil. Table 1 shows an increase in the number of HZ diagnoses over the years, and Table 2 shows the negative impact from the COVID-19 disease, revealing an increase in the number of mortality/100 thousand inhab.: 106,8. Out of the limitations of this study, we can mention cases that are not notified to Brazilian public health system, suggesting that the real incidence could be higher.

Therefore, although the association between HZ and COVID-19 is not well stablished, we observed in this study an increase in HZ cases during the COVID -19 pandemic, which suggests a correlation between these diseases. Thus, controlled clinical studies are necessary to define whether this relationship exists.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

J o u r n a l P r e -p r o o f 

Banco de dados público (DATASUS)

Saúde Do Bras n

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*The Federal District encompasses the capital of Brazil, Brasília. Regions of Brazil State