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Introduction: Chronic obstructive pulmonary disease (COPD) is a major cause of worldwide morbidity and mortality, being associated with high prevalence of mental disorders. Therefore, we analysed men with self-reported COPD regarding socio-demographic data and several dimensions of mental health.

Methods: We analysed data from a population-based survey with a representative sample of Portuguese men aged ≥40 years (n=5,707), in 2014. We performed an age- and education-adjusted comparison of the prevalence of depression diagnosis, use of mental health consultations and different dimensions of mental health disease according to self-reported COPD diagnosis. We estimated weighted prevalences with 95% confidence intervals (95%CI) and adjusted prevalence ratios (PR) using Poisson regression. This study was approved by ethics committee.

Results: The nationwide prevalence of COPD in men was 6.4% (95%CI: 5.5-7.2), increasing with age, with a prevalence of 13.7% (95%CI: 10.8-16.6) for ≥75-year-old men. Men with COPD had an adjusted higher prevalence of depression diagnosis [PR=2.07 (1.45-2.98)]. They also reported more commonly life insatisfaction [PR=1.57 (1.23-2.00)], perceiving health-status as bad [PR=1.76 (1.44-2.16)], indifference for daily activities [PR=1.68 (1.39-2.03)], depressed mood [PR=1.67 (1.40-1.98)], sleep disturbances [PR=1.40 (1.20-1.62)], fatigue [PR=1.63 (1.44-1.84)], feeling of worthlessness or guilt [PR=2.13 (1.71-2.66)] and difficulty in concentrating [PR=1.62 (1.23-2.19)].

Conclusion: These findings provide evidence that COPD is associated with mental health, namely depression, being a major component of the burden of this disease among men. The clinicians should be aware of this association in order to have a high level of suspicion to mental health disturbances when assessing men with COPD.

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Introduction: Skin lesions observed in the context of SARS-CoV-2 infection are a target of growing interest in the scientific community. Their early identification may be useful for establishing an accurate diagnosis and prognosis.

Case description: DF, female, 39 years old, geriatrics assistant, without previous pathological history, oral contraceptive as the only usual medication, reported a mild skin reaction in her limbs, four days after administration of the flu vaccine. This reaction lasted less than 24 hours without any treatment. Three weeks later, DF reported appearance of pruritic stains all over her body including pelvic area. She went to the hospital emergency department and was treated with an oral antihistaminic and a local corticoid, without clinical improvement. Five days later, she tested positive for COVID-19. Her only symptom during clinical surveillance by her family doctor was tiredness. After completing an isolation period, DF was referred to a dermatology consultation due to rash persistence. She had confluent patches in her abdomen, post-inflammatory hyperpigmentation areas on her trunk and limbs, and secondary abrasions, which corroborate urticaria diagnosis. The analytical study didn’t reveal any change, and DF was medicated with a different oral antihistaminic with partial improvement.

Discussion: Urticaria is one of the first skin manifestations of COVID-19 infection. It may occur at the beginning, previous to or simultaneous with other symptoms. In this case report, although we can’t exclude a possible adverse effect of the influenza vaccine, SARS-CoV-2 seems to be the trigger factor for first presentation and exacerbation of a dermatological disease.