13-year-old Struggles to Walk After Having COVID Toes for Nine Months

A teenager with a condition known as "COVID toes" has been struggling to walk for nine months because of her swollen, blistered feet.

The 13-year-old from Scotland, U.K., identified only as Sofia, has been dealing with a severe case of the condition since October. She has been out of school and needs a wheelchair if she has to walk a long distance, she told BBC Scotland's The Nine.

"Before this, I was singing, dancing and just running around the place. Now I can't really do that so it's very different," she said.

The condition is characterized by discolored, swollen toes that look like they have chilblains, according to the American Academy of Dermatology (AAD). The fingers can also be affected. At first, the digits may be bright red before turning purple, although they may start off as purple.

COVID toes is a less common symptom of the virus and may be the only sign of an infection in some people. It can affect people of any age, although children, teenagers, and young adults appear to be most likely to have it. Many COVID toes patients do not develop other COVID symptoms such as a dry cough, muscle aches, or fever, and if they do they are generally mild.

Sofia told BBC Scotland's The Nine: "My feet swell up, I get blisters all over them and they go from pink to purple really quickly... I get lumps on the bottom of them which makes it really hard to stand up for long. I can only wear flip-flops."

Sofia has not tested positive for COVID. Explaining how this is possible, podiatrist Martin McCafferty said one theory is that COVID toes can appear towards the end of a person's infection so they would not receive a positive PCR test.

"Another is that these patients release interferon which means they will rapidly clear the virus before any real immunity is built up—leaving these chilblain type legions," he said.

Dr. Esther Freeman, principal investigator of the AAD's COVID-19 Dermatology Registry, told Newsweek: "We see COVID toes patients with relatively mild COVID. We think this is because COVID toes go along with a 'good' or 'robust' immune response to the virus.

"Younger people tend to have more robust immune systems, and tend to have less severe COVID. This robust immune response can manifest itself by turning toes purple."

The AAD recommends people with COVID toes use hydrocortisone cream, a type of anti-inflammatory treatment, to relieve pain and itching, before visiting a board-certified dermatologist if this does not help.

The condition can fade on its own, but it is too early to know how long COVID toes last. Dr. Amy Paller, a pediatric dermatologist and chair of dermatology at Northwestern Feinberg School of Medicine, told the AAD some patients have COVID toes for 10 to 14 days, but others can have it for months.

Sofia's mother Gaby said dermatologists have run tests on her daughter and treated her with creams and medications "but they've kind of run out of ideas."

To try to calm her feet, Sofia places them in a foot spa with warm water and bath salts.

She said: "It's kind of scary because I don't really know what's happening... I don't know if I'll be able to do the things that I like to do in the future."

This article has been updated with comment from Dr. Esther Freeman.

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A stock image shows a person with COVID toes. Sofia has been struggling with the condition for months.