Abstract: 【Abstract】 Objective To characterize COVID-19-associated skin diseases and explore their influencing factors. Methods A cross-sectional survey was conducted via the online platform Wenjuanxing in Changsha area from February 16, 2023, to March 16, 2023. The convenience sampling method was employed to conduct a survey of outpatients with a history of COVID-19 infection from the Second Affiliated Hospital of Hunan University of Chinese Medicine, as well as individuals in certain areas of Changsha who met the inclusion criteria for past COVID-19 infections. Demographic characteristics, COVID-19 infection details, and the occurrence of skin conditions after COVID-19 infection were collected. The chi-square test was used for inter-group comparisons of categorical data, and multivariate logistic regression analysis was performed to investigate factors associated with skin diseases following COVID-19 infection. Results A total of 357 valid questionnaires were collected, and 357 patients with a history of COVID-19 infection were involved, including 246 females （68.9%） and 111 males （31.1%）. Among these patients, 260 （72.8%） were aged ≤ 35 years. After COVID-19 infection, skin diseases occurred in 96 patients （26.9%）, with urticaria （27 cases, 31.0%）, rosacea （27 cases, 31.0%）, hair loss （18 cases, 20.7%）, and Henoch-Sch?nlein purpura （15 cases, 17.2%） being the most common diseases. Additionally, 96 patients （26.9%） had a history of pre-existing skin diseases, among whom 36 experienced exacerbation of their pre-existing skin diseases due to COVID-19 infection. Univariate analysis showed that gender, history of chronic diseases, history of allergic diseases, COVID-19 vaccination, duration of COVID-19 infection, and exacerbation of pre-existing skin diseases were significantly associated with the development of new skin diseases following COVID-19 infection （all P < 0.05）. Multivariate logistic regression analysis revealed that gender （compared with females, males: OR = 0.235, 95% CI: 0.113, 0.490）, history of allergic diseases （compared with patients without a history of allergic diseases, those with the history: OR = 2.159, 95% CI: 1.239, 3.761）, and duration of COVID-19 infection （compared with the duration of < 5 days, duration of 6 - 7 days: OR = 3.043, 95% CI: 1.495, 6.193; duration of 8 - 14 days: OR = 2.364, 95% CI: 1.105, 5.506; duration of ≥ 15 days: OR = 4.406, 95% CI: 1.972, 9.849） were influencing factors for skin diseases after COVID-19 infection （all P < 0.05）. Conclusions COVID-19 infection may lead to skin diseases such as urticaria, rosacea, hair loss, and Henoch-Sch?nlein purpura. Females, individuals with a history of allergic diseases, and those with a relatively long duration of COVID-19 infection were more prone to develop skin diseases after COVID-19 infection.

Key words: SARS-CoV-2, Coronavirus disease 2019, Skin diseases, Cross-sectional studies, Influencing factors