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

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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:

E.V. Ikonnikova

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

N.E. Manturova

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

SPIN RSCI: 5232-0412
Scopus AuthorID: 55461712100
ORCID: 0000-0003-4281-1947

L.S. Kruglova

Central State Medical Academy of Department of Presidential Affairs

Scopus AuthorID: 24168854300
ORCID: 0000-0002-5044-5265

Received:

11.08.2021

Accepted:

20.08.2021

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