Not long after the start of the COVID-19 pandemic there started to be increased observations of chilblains occurring in the toes of those who had COVID-19. The number of reports were a lot more than you would expect to see of just the normal incidence of chilblains. Those with COVID-19 who got chilblains were occurring in people who do not normally get chilblains and were in climates that there is not normally much chilblains. On some occasions the chilblains were occurring before the other symptoms of COVID-19.
After those initial observations research did confirm the increased prevalence of chilblains of the toes in those with COVID-19 and confirmed the existence of the thing called ‘COVID Toes’. The research on the mechanism that followed that initial research has shown mixed results. Some of the research has found inflammatory markers in the chilblains that linked them directly to the pathophysiological processes of COVID-19. Other studies have not found that physiological link. You can track that research here. It could be possible that the reason for the increased prevalence of chilblains is not due to the inflammatory processes of COVID-19, but could be due to behavioral changes that occurred during the lockdowns. People spent less time wearing shoes and more time in air-conditioned houses, which could have increased the risk for getting a ‘normal’ chilblain and not one directly associated with COVID-19. Of course, there is always going to be the coincidence of someone getting a chilblain at the same time as they had COVID-19.
The symptoms of a COVID toe are no different to those of a typical chilblain that is commonly seen in the cooler climates. They typically start as a red itchy and painful patch on the skin that then becomes a darker bluish color. It can be a challenge to differentiate a regular chilblain from a COVID toe as the only way of really telling is that the person with the chilblain also has COVID-19 symptoms. The treatment of COVID toes is no different to the treatment of a regular chilblain. Keep the feet warm and use a cream to gently stimulate the circulation and wait for the chilblain to run its course.