Unravelling Beau's lines as a potential indicator of severe immune response in COVID-19 and reinfection
  • Aris P. Agouridis
    School of Medicine, European University Cyprus, Nicosia, Cyprus; Department of Internal Medicine, German Oncology Center, Limassol, Cyprus
  • Evangelia E. Ntzani
    Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece; Center for Evidence-Based Medicine, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, USA
  • Georgia Anastasiou
    Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
  • Fotios Barkas
    Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece
  • Evangelos C. Rizos
    School of Medicine, European University Cyprus, Nicosia, Cyprus; School of Nursing, University of Ioannina, Ioannina, Greece


Beau's lines, COVID-19, interleukin-6


Background: Beau's lines are transverse grooves in the nail plate that result from transient interruption of the growth of the proximal nail matrix. These rare nail disorders can be triggered mostly by infections or systemic diseases.
Case Description: We describe a 65-year-old man who presented with nail changes on all fingernails. The patient, a non-smoker with no medication history, had severe immune responses during two hospitalisations, 9 and 4 months ago, for COVID-19. Both hospitalisations were accompanied by markedly elevated interleukin-6 levels, and treatment with tocilizumab on top of dexamethasone was required. The present examination revealed Beau's lines which were associated with both prior COVID-19 infections.
Conclusions: Although nail changes look harmless, seeking Beau's lines during the physical examination might indicate past severe COVID-19 infection and a higher probability for reinfection and rehospitalisation.



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    Published: 2024-01-17
    Issue: 2024: Vol 11 No 2 (view)

    How to cite:
    Agouridis AP, Ntzani EE, Anastasiou G, Barkas F, Rizos EC. Unravelling Beau’s lines as a potential indicator of severe immune response in COVID-19 and reinfection. EJCRIM 2024;11 doi:10.12890/2024_004281.