What are COVID Nails: Unusual symptom in COVID-19 survivors [don't panic]

As the COVID-19 pandemic has progressed, there has been no dearth of 'weird' symptoms that accompany the viral disease. However, they do not end as soon as the SARS-CoV-2 coronavirus has run its course in the body. From 'brain fog' to heart palpitations to altered smell and taste, the post-infection symptoms can persist for weeks or even months. Now, scientists have begun bringing attention to another symptom that may serve as a testament to one's tryst with the spiked virus—COVID nails.

Human nails can serve as an indicator of an individual's overall health. According to experts, as unusual as it may seem, the symptom of the nails can reveal the effect of the novel coronavirus infection on a survivor's body. So what are COVID nails? Let's take a look.

Lingering Post-Infection Symptoms

While testing negative after a bout of COVID-19 is cause for celebration, the persistence of symptoms can be as taxing as the illness itself. Some of the common symptoms that may linger include headache, fever, dizziness, shortness of breath or difficulty in breathing, fatigue, joint and muscle aches, loss of taste or smell (or both), and difficulty in cognitive functions (also known as brain fog), among others. These symptoms can last for a few weeks, often in combination with each other. However, in the case of 'COVID long-haulers', they can last for months.

Health experts state that these symptoms could be the body's coping mechanism or vestigial side-effects of the hard-on-the-body viral disease. The buzz surrounding COVID Nails began after Dr. Tim Spector, professor of genetic epidemiology at King's College, London, brought attention to the symptom. In his tweet, the epidemiologist who was involved in the COVID Symptom Study—a mobile application that tracks symptoms—averred that the symptom is "increasingly being recognized" as a sign of recovery of nails post-infection. 

Lines on Nails 

Identifying the symptom is rather easy. It is characterized by a 'clear line'—medically known as 'Beau's lines'—on the nail bed. The feature was first described in 1846 by French physician Joseph Honoré Simon Beau. While the exact reason behind the connection between Beau's lines with COVID-19 recovery remains elusive, clinicians posit that it could be the cuticular manifestation of the enormous toll the body is subjected to by sickness or stress.

According to several case studies, COVID nails can arise weeks, or even months, after beating the SARS-CoV-2 coronavirus infection. It is not confined to nails in the hand and can appear on toenails also. The most prominent indicator of the potential residual side-effect is 'grooves' that ran across the length of the nail plate. They are mostly white in colour.

However, indentations and ridges are other forms that Beau's lines may take. Also, they can appear on more than one nail simultaneously. Despite being prevalent enough in COVID-19 survivors to warrant studies, experts suggest that the peculiar side-effect may not affect all patients. In some survivors, it may not be discernible enough and may miss notice entirely.

Dr. Michele S. Green, a dermatologist at Lenox Hill Hospital, New York, told Healthline, "It may take several months after having had the illness for Beau's lines to appear, and they may not appear at all despite having COVID," said Green. Talking to The Washington Post, Dr. Jeffrey Weinberg, associate clinical professor of dermatology at Mount Sinai, remarked "could happen with anything that perturbs the body", thus, highlighting that it is not an exclusive symptom associated with COVID-19 alone.

No Cause For Worry

While Beau's lines are being observed in recovering COVID-19 survivors, it is not unheard of or new. Several factors can lead to the appearance of depression on the nail bed. These include comorbidities such as vascular diseases and severe diabetes, viral infection, and acute illness. Much like other forms of inflammations that are caused in the body due to COVID-19, the nail symptom could be an inflammatory response similar to those observed in the skin.

According to researchers, as the coronavirus infection has a long recovery time, nail health could be adversely impacted as well. Medications for extended periods of time, such as chemotherapy, are also known to give rise to Beau's lines. As several COVID-19 patients require extensive medication during treatment, and prolonged prescription for recovery post-infection, the groves could be a result of it.

So the important question is: Should one be worried about COVID Nails? Not really, says Dr. Shari Lipner, a dermatologist at Weill Cornell Medicine, New York. Like other experts, Dr. Shari also opines that it is nothing more than proof of the body's recovery from a major sickness. She told The Washington Post, "It's really not something to be concerned about. It's really just saying that something happened to your body beforehand."

As far as treatment goes there is nothing much that can be done other than waiting for the nails to grow out completely, noted Dr. Green. "There is little to do as far as treatment for the appearance of Beau's lines. The entire fingernail will grow and replace itself within 6 months, meaning that if the underlying cause of the Beau's line or lines is treated, they'll disappear on their own with time," she said. However, she emphasized that it is important to seek medical attention if the grooves do not grow out or appear more often.