The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Ikonnikova E.V.

Central State Medical Academy of Administrative Directorate of the President of the Russian Federation;
Institute of Plastic Surgery and Cosmetology

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

Kruglova L.S.

Central State Medical Academy of Department of Presidential Affairs

COVID-19 and delayed inflammatory reactions to hyaluronic acid fillers: what we know about it?

Authors:

Ikonnikova E.V., Manturova N.E., Kruglova L.S.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2021;(3): 68‑74

DOI: 10.17116/plast.hirurgia202103168

Read: 19738 times

Download PDF (RU)
Download PDF
Contact the author
Table of contents

COVID-19 AND DELAYED INFLAMMATORY REACTIONS TO HYALURONIC ACID FILLERS: WHAT WE KNOW ABOUT IT?
COVID-19 AND DELAYED INFLAMMATORY REACTIONS TO HYALURONIC ACID FILLERS: WHAT WE KNOW ABOUT IT?

To cite this article:

Ikonnikova EV, Manturova NE, Kruglova LS. COVID-19 and delayed inflammatory reactions to hyaluronic acid fillers: what we know about it? Plastic Surgery and Aesthetic Medicine. 2021;(3):68‑74. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202103168

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Study of hardware methods impact on the physical properties of hyaluronic acid-based tissue fillers in expe­riment. Russian Journal of Clinical Dermatology and Vene­reology. 2025;(1):22-28
Fatal non-thrombotic pulmonary embo­lism in penis enla­rgement with inje­ctions of hyaluronic acid-based drugs. Fore­nsic Medi­cal Expe­rtise. 2025;(1):59-62
Instrumental and labo­ratory indi­cators in evaluating the effe­ctiveness of suba­ntral sinus lifting in severe bone atro­phy. Russian Journal of Operative Surgery and Clinical Anatomy. 2025;(1):48-55
Early complications after surgical treatment of spontaneous pneumothorax: risk factors analysis. Piro­gov Russian Journal of Surgery. 2025;(3):24-32
The role of early predictors in diagnosis of stapler suture and anastomotic failure in bariatric patients. Piro­gov Russian Journal of Surgery. 2025;(3):76-86
A clinical case of the aortic rupture after SARS-CoV-2 in the patient with Stickler syndrom. Russian Journal of Preventive Medi­cine. 2025;(3):103-106
Possibilities surgical treatment of atypical forms of pelvic organ prolapse. Endo­scopic Surgery. 2025;(2):35-42
Transluminal extraction of intramural duodenal wall calculus after videolaparoscopic cholecystectomy. Endo­scopic Surgery. 2025;(2):50-55
Controversial issues of colon stenting in case of tumor obstructive inte­stinal obstruction: surgical and onco­logical aspe­cts. Endo­scopic Surgery. 2025;(2):65-75
A rational approach to the prevention and treatment of ARVI and influenza, as a medico-economic and socially significant problem of the XXI century. Journal of Respiratory Medi­cine. 2025;(1):43-48
Abstract:

ACTUALITY

In recent years in aesthetic medicine, there has been a steadily increasing popularity of the use of various fillers in order to correct aesthetic imperfections and age-related changes. Traditionally, the most widely used fillers are based on hyaluronic acid due to their high safety profile, biocompatibility, a wide range of indications and the presence of an antidote in the form of hyaluronidase preparations. However, in some cases, a late complication such as a delayed inflammatory response may occur. Various triggering factors can lead to its appearance, including influenza-like illnesses, and also coronavirus infection caused by the SARS-CoV-2 virus.

OBJECTIVE

The article provides a detailed description of the occurrence of a delayed inflammatory reaction in the localization of a filler based on hyaluronic acid against the background of a new coronavirus infection (COVID-19), as well as analyzes clinical cases presented in scientific publications.

MATERIAL AND METHODS

A 49-year-old female patient complained of recurrent inflammation in the areas of injection of a filler based on hyaluronic acid. For the first time, the onset of an inflammatory reaction occurred against the background of the COVID-19 disease.

RESULTS

After additional examination methods (ultrasound of the skin and soft tissues of the face), a diagnosis was made and therapy was prescribed (antibiotics, dexamethasone per os for a long time, enzymatic resorption of the filler by hyaluronidase, external therapy: tacrolimus).

CONCLUSIONS

Delayed inflammatory responses of hyaluronic acid fillers, despite the rarity of occurrence, are currently the focus of attention. The worldwide interest in this problem is associated with the etiology and pathogenesis of their occurrence, which are complex and multifactorial and are not fully understood. As practical observations show during the ongoing pandemic, the SARS-CoV-2 virus may be a risk factor for the occurrence of delayed inflammation in this category of patients with an aesthetic profile.

Keywords:

complications
fillers
hyaluronic acid
viral infections
hypersensitivity
immunology
COVID-19
SARS-CoV-2
coronavirus infection

Authors:

Ikonnikova E.V.

Central State Medical Academy of Administrative Directorate of the President of the Russian Federation;
Institute of Plastic Surgery and Cosmetology

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

Kruglova L.S.

Central State Medical Academy of Department of Presidential Affairs

Received:

11.08.2021

Accepted:

20.08.2021

Close metadata

References:

  1. ISAPS. International survey on aesthetic/cosmetic procedures. 2019. https://www.isaps.org/wp-content/uploads/2020/12/Global-Survey-2019.pdf
  2. Mo W, Yang C, Liu Y, He Y, Wang Y, Gao F. The influence of hyaluronic acid on vascular endothelial cell proliferation and the relationship with ezrin/merlin expression. Acta Biochem Biophys Sin. 2011;43:930-939.  https://doi.org/10.1093/abbs/gmr094
  3. Giji S, Arumugam M. Isolation and characterization of hyaluronic acid from marine organisms. Adv Food Nutr Res. 2014;72:61-77.  https://doi.org/10.1016/B978-0-12-800269-8.00004-X
  4. Maytin E. Hyaluronan: More than just a wrinkle filler. Glycobiology. 2016; 26(6):553-559.  https://doi.org/10.1093/glycob/cww033
  5. Beleznay K, Carruthers JD, Carruthers A, Mummert ME, Humphrey S. Delayed-onset nodules secondary to a smooth cohesive 20 mg/mL hyaluronic acid filler: cause and management. Dermatol Surg. 2015;41(8):929-939.  https://doi.org/10.1097/DSS.0000000000000418
  6. Alijotas-Reig J, Fernandez-Figueras MT, Puig L. Inflammatory, immune-mediated adverse reactions related to soft tissue dermal fillers. Semin Arthritis Rheum. 2013;43(2):241-258.  https://doi.org/10.1016/j.semarthrit.2013.02.001
  7. De Boulle K, Heydenrych I. Patient factors influencing dermal filler complications: prevention, assessment, and treatment. Clin Cosmet Investig Dermatol. 2015;8:205-214.  https://doi.org/10.2147/CCID.S80446
  8. Funt D, Pavicic T. Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clin Cosmet Investig Dermatol. 2013;6:295-316.  https://doi.org/10.2147/CCID.S50546.
  9. Lemperle G, Rullan PP, Gauthier-Hazan N. Avoiding and treating dermal filler complications. Plast Reconstr Surg. 2006;118(3):92-107.  https://doi.org/10.1097/01.prs.0000234672.69287.77
  10. Artzi O, Loizides C, Verner I, Landau M. Resistant and recurrent late reaction to hyaluronic acid-based gel. Dermatol Surg. 2016;42(1):31-37.  https://doi.org/10.1097/DSS.0000000000000562
  11. Alijotas-Reig J, Fernandez-Figueras MT, Puig L. Late-onset inflammatory adverse reactions related to soft tissue filler injections. Clin Rev Allergy Immunol. 2013;45(1):97-108.  https://doi.org/10.1007/s12016-012-8348-5
  12. Artzi O, Cohen JL, Dover JS, et al. Delayed inflammatory reactions to hyaluronic acid fillers: a literature review and proposed treatment algorithm. Clin Cosmet Investig Dermatol. 2020;13:371-378.  https://doi.org/10.2147/CCID.S247171
  13. Turkmani MG, De Boulle K, Philipp-Dormston WG. Delayed hypersensitivity reaction to hyaluronic acid dermal filler following influenza-like illness. Clin Cosmet Investig Dermatol. 2019;12:277-283.  https://doi.org/10.2147/ccid.S198081
  14. Ikonnikova EV, Manturova NE, Kruglova LS. Otsrochennaya vospalitel’naya reaktsiya na fillery na osnove gialuronovoj kisloty na fone grippopodobnogo zabolevaniya. Rossijskij zhurnal kozhnykh i venericheskikh boleznej. 2021; 24(1):5-12.  https://doi.org/10.17816/dv61472
  15. Rowland-Warmann MJ. Hypersensitivity reaction to hyaluronic acid dermal filler following novel coronavirus infection — a case report. J Cosmet Dermatol. 2021;20(5):1557-1562. https://doi.org/10.1111/jocd.14074
  16. Munavalli GG, Guthridge R, Knutsen-Larson S, Brodsky A, Matthew E, Landau M. COVID-19/SARS-CoV-2 virus spike protein-related delayed inflammatory reaction to hyaluronic acid dermal fillers: a challenging clinical conundrum in diagnosis and treatment. Arch Dermatol Res. 2021. https://doi.org/10.1007/s00403-021-02190-6
  17. Munavalli GG, Knutsen-Larson S, Lupo MP, Geronemus RG. Oral angiotensin-converting enzyme inhibitors for treatment of delayed inflammatory reaction to dermal hyaluronic acid fillers following COVID-19 vaccination — a model for inhibition of angiotensin II-induced cutaneous inflammation. JAAD Case Rep. 2021;10:63-68.  https://doi.org/10.1016/j.jdcr.2021.02.018
  18. Curi MM, Cardoso CL, Curra C. Late-onset adverse reactions related to hyaluronic acid dermal filler for aesthetic soft tissue augmentation. J Craniofac Surg. 2015;26(3):782-784.  https://doi.org/10.1097/SCS.0000000000001358
  19. Gotkin RH, Gout U, Sattler S. Global recommendations on covid-19 vaccines and soft tissue filler reactions: a survey-based investigation in cooperation with the international society for dermatologic and aesthetic surgery (ISDS). J Drugs Dermatol. 2021;20(4):374-378.  https://doi.org/10.36849/JDD.2021.6041
  20. Jordan AR, Racine RR, Hennig MJP. The role of CD44 in disease pathophysiology and targeted treatment. Front Immunol. 2015;6:182.  https://doi.org/10.3389/fimmu.2015.00182
  21. Motolese A, Vignati F, Brambilla R, Cerati M, Passi A. Interaction between a regenerative matrix and wound bed in nonhealing ulcers: results with 16 cases. Biomed Res Int. 2013;2013:849321. https://doi.org/10.1155/2013/849321
  22. Tian X, Azpurua J, Hine C, Vaidya A, Myakishev-Rempel M, Ablaeva J, et al. High-molecular-mass hyaluronan mediates the cancer resistance of the naked mole rat. Nature. 2013;499(7458):346-349.  https://doi.org/10.1038/nature12234
  23. Tammi MI, Day AJ, Turley EA. Hyaluronan and homeostasis: a balancing act. J Biol Chem. 2002;277(7):4581-4584. https://doi.org/10.1074/jbc.R100037200
  24. Slevin M, Krupinski J, Gaffney J, Matou S, West D, Delisser H, et al. Hyaluronan-mediated angiogenesis in vascular disease: uncovering RHAMM and CD44 receptor signaling pathways. Matrix Biol. 2007;26(1):58-68.  https://doi.org/10.1016/j.matbio.2006.08.261
  25. Mikkilineni R, Wipf A, Farah R. New classification schemata of hypersensitivity adverse effects after hyaluronic acid injections: pathophysiology, treatment algorithm, and prevention. Dermatol Surg. 2020;46(11):1404-1409. https://doi.org/10.1097/DSS.0000000000002385
  26. Mummert ME. Immunologic roles of hyaluronan. Immunol Res. 2005;31: 189-205.  https://doi.org/10.1385/IR:31:3:189
  27. Ciccone V, Zazzetta M, Morbidelli L. Comparison of the effect of two hyaluronic acid preparations on fibroblast and endothelial cell functions related to angiogenesis. Cells. 2019;8(12):1479. https://doi.org/10.3390/cells8121479
  28. De Boulle K, Glogau R, Kono T, et al. A review of the metabolism of 1,4-butanediol diglycidyl ether-crosslinked hyaluronic acid dermal fillers. Dermatol Surg. 2013;39(12):1758-1766. https://doi.org/10.1111/dsu.12301
  29. Arleevskaya MI, Manukyan G, Inoue R, Aminov R. Microbial and environmental factors in autoimmune and inflammatory diseases. Front Immunol. 2017;8:243.  https://doi.org/10.3389/fimmu.2017.00243
  30. Decates TS, Velthuis PJ, Schelke LW. Increased risk of late-onset, immune-mediated, adverse reactions related to dermal fillers in patients bearing HLA-B*08 and DRB1*03 haplotypes. Dermatol Ther. 2021;34:e14644. https://doi.org/10.1111/dth.14644
  31. Smatti MK, Cyprian FS, Nasrallah GK, Thani AA, Almishal RO, Yassine HM. Viruses and autoimmunity: a review on the potential interaction and molecular mechanisms. Viruses. 2019;11(8):762.  https://doi.org/10.3390/v11080762
  32. Liu Y, Sawalha AH, Lua Q. COVID-19 and autoimmune diseases. Curr Opin Rheumatol. 2021;33(2):155-162.  https://doi.org/10.1097/BOR.0000000000000776
  33. Li M, Li L, Zhang Y, Wang X. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020; 9(1):45.  https://doi.org/10.1186/s40249-020-00662-x
  34. Verdecchia P, Cavallini C, Spanevello A. The pivotal link between ACE2 deficiency and SARS-CoV-2 infection. Eur J Intern Med. 2020;76:14-20.  https://doi.org/10.1016/j.ejim.2020.04.037
  35. Scholzen TE, Ständer S, Riemann H, Brzoska T, Luger TA. Modulation of cutaneous inflammation by angiotensin-converting enzyme. J Immunol. 2003;170(7):3866-3873. https://doi.org/10.4049/jimmunol.170.7.3866
  36. Silva IMS, Assersen KB, Willadsen NN, Jepsen J, Artuc M, Steckelings UM. The role of the renin-angiotensin system in skin physiology and pathophysiology. Exp Dermatol. 2020;29(9):891-901.  https://doi.org/10.1111/exd.14159
  37. Hedayatyanfard K, Haddadi NS, Ziai SA, Karim H, Niazi F, Steckelings UM, et al. The renin-angiotensin system in cutaneous hypertrophic scar and keloid formation. Exp Dermatol. 2020;29(9):902-909.  https://doi.org/10.1111/exd.14154
  38. Bhojani-Lynch T. Late-onset inflammatory response to hyaluronic acid dermal fillers. Plast Reconstr Surg Glob Open. 2017;5(12):e1532. https://doi.org/10.1097/GOX.0000000000001532
  39. Michon A. Hyaluronic acid soft tissue filler delayed inflammatory reaction following COVID-19 vaccination — a case report. J Cosmet Dermatol. 2021. Online. https://doi.org/10.1111/jocd.14312
  40. Danese E, Montagnana M, Salvagno GL, Peserico D, Pighi L, De Nitto S, et al. Comprehensive assessment of humoral response after Pfizer BNT162b2 mRNA Covid-19 vaccination: a three-case series. Clin Chem Lab Med. 2021. Online. https://doi.org/10.1515/cclm-2021-0339
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.