healthcare Article Cutaneous Manifestations in SARS-CoV-2 Infection—A Series of Cases from the Largest Infectious Diseases Hospital in Western Romania Ruxandra Laza 1,2 , Virgil Filaret Musta 1,2 , Narcisa Daniela Nicolescu 1,2 , Adelina Raluca Marinescu 1,2,3, *, Alexandra Mocanu 2,3 , Laura Vilceanu 2 , Roxana Paczeyka 2 , Talida Georgiana Cut 1,2,3 and Voichita Elena Lazureanu 1,2   Citation: Laza, R.; Musta, V.F.; Nicolescu, N.D.; Marinescu, A.R.; Mocanu, A.; Vilceanu, L.; Paczeyka, R.; Cut, T.G.; Lazureanu, V.E. Cutaneous Manifestations in SARS-CoV-2 Infection—A Series of Cases from the Largest Infectious Diseases Hospital in Western Romania. Healthcare 2021, 9, 800. https://doi.org/10.3390/ healthcare9070800 Academic Editors: Pierpaolo Di Micco and Anna Annunziata Received: 29 May 2021 Accepted: 23 June 2021 Published: 25 June 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Department XIII, Discipline of Infectious Diseases, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania; ruxi_martincu@yahoo.com (R.L.); musta.virgil@umft.ro (V.F.M.); nicolescu.narcisa@umft.ro (N.D.N.); talida.cut@umft.ro (T.G.C.); lazureanu.voichita@umft.ro (V.E.L.) 2 Clinical Hospital of Infectious Diseases and Pneumophtisiology “Doctor Victor Babes” Timisoara, Gheorghe Adam, Nr. 13, 300310 Timisoara, Romania; alexandramocanu021@yahoo.com (A.M.); vilceanulaura10@gmail.com (L.V.); roxy_klopo@yahoo.com (R.P.) 3 Doctoral School, University of Medicine and Pharmacy “Victor Babes” Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania * Correspondence: marinescu_adelina24@yahoo.com; Tel.: +40-764734396 Abstract: (1) Background: SARS-CoV-2 infection, which appeared as an isolated epidemic outbreak in December 2019, proved to be so contagious that, within 3 months, the WHO declared COVID-19 a pandemic. For one year (pre-vaccination period), the virus acted unhindered and was highly contagious, with a predominantly respiratory-oriented aggression. Although this lung damage, responsible for the more than 3,090,025 deaths, has provided sufficient data to facilitate the under- standing of pathogenic mechanisms, other observation data, which meet the quality of emerging clinical aspects, such as rashes, remain without well-defined etiopathogenic support or a well- contoured clinical framework. (2) Methods and Results: We followed the occurrence of cutaneous manifestations in patients hospitalized during the second and third outbreak of SARS-CoV-2 in the main clinics of infectious diseases of our county, Timis, and recorded laboratory investigations and clinical evolution for five suggestive cases. (3) Conclusions: The presented cases, added to many other present and future clinical observations, will allow for better knowledge and understanding of SARS-CoV-2 infection, a requirement that has become a global priority for the entire medical and scientific community. Keywords: SARS-CoV-2; cutaneous manifestations; erythematous-macular rash; immune response 1. Introduction The presence of coronaviruses in human pathology offers us a model of natural evolution of the relationship between the living world of microorganisms and humanity, that is, between virus and human [1]. Since they were first isolated (1965), they have behaved as infectious agents with low pathogenicity, causing seasonal cough or benign enteritis. Gradually, under the action of mutational factors related to microbial ecology, the environment, and successive transitions in various populations, they acquired new qualities and epidemiologic strains developed [2]. Their new qualities of contagiousness, invasiveness, and pathogenicity have ensured their ability to trigger severe acute respiratory syndrome (SARS-CoV-1), which concluded in 2002/2003 with 8000 cases and 774 deaths in over 26 countries and 5 continents [3]. Ten years after SARS-CoV-1, another highly pathogenic coronavirus, Middle East respira- tory syndrome coronavirus (MERS-CoV), emerged in the Arabian Peninsula, with a case Healthcare 2021, 9, 800. https://doi.org/10.3390/healthcare9070800 https://www.mdpi.com/journal/healthcare