Detection of COVID-19 in a Vulvar Lesion
As new information about coronavirus disease 2019 (COVID-19) is rapidly discovered, clinicians are better equipped to make informed decisions for their patients. While current research suggests COVID-19 viral antigen is not found in vaginal secretions, its detectability in the female lower genital tract may have clinical implications for obstetric and gynecologic care for women. We present a case of a woman at 31 weeks' gestation with simultaneous upper respiratory symptoms and vulvovaginitis. She was found to have a vulvar lesion positive for severe acute respiratory syndrome-COVID by viral swab. This case shows that COVID-19 is detectable in the vulva. This may have implications for health care workers' exposure and personal protective equipment needs. While vertical transmission has largely not been reported, the presence of detectable virus in the female lower genital tract makes this a continued possibility and area of study.
COVID-19 is detectable in the female lower genital tract.
The detection of COVID-19 in the vulva may have implications for personal protective equipment use.
The detection of COVID-19 in vulvovaginal lesions makes vertical transmission a continued possibility.
KeywordsCOVID-19 - vulvar lesion - viral swab - vertical transmission - personal protective equipment
* These authors contributed equally to this work.
Received: 22 May 2020
Accepted: 30 May 2020
02 July 2020 (online)
© 2020. Thieme. All rights reserved.
Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.
- 1 Qiu L, Liu X, Xiao M. , et al. SARS-CoV-2 is not detectable in the vaginal fluid of women with severe COVID-19 infection. Clin Infect Dis 2020; ciaa375 . Doi: 10.1093/cid/ciaa375
- 2 Cui P, Chen Z, Wang T. , et al. Severe acute respiratory syndrome coronavirus 2 detection in the female lower genital tract. Am J Obstet Gynecol 2020; ; S0002-9378(20)30523-8 DOI: 10.1016/j.ajog.2020.04.038.
- 3 Landa N, Mendieta-Eckert M, Fonda-Pascual P, Aguirre T. Chilblain-like lesions on feet and hands during the COVID-19 Pandemic. Int J Dermatol 2020; 59 (06) 739-743
- 4 Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill 2020; 25 (10) 2000180
- 5 Sutton D, Fuchs K, D'Alton M, Goffman D. Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med 2020; 382 (22) 2163-2164
- 6 Day M. Covid-19: four fifths of cases are asymptomatic, China figures indicate. BMJ 2020; 369: m1375
- 7 Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med 2020; DOI: 10.5858/arpa.2020-0901-SA.
- 8 Alzamora MC, Paredes T, Caceres D, Webb CM, Valdez LM, La Rosa M. Severe COVID-19 during pregnancy and possible vertical transmission. Am J Perinatol 2020; DOI: 10.1055/s-0040-1710050.
- 9 Kimberlin DW, Stagno S. Can SARS-CoV-2 infection be acquired in utero?: more definitive evidence is needed. JAMA 2020; DOI: 10.1001/jama.2020.4868.