Factors associated with adverse COVID-19 outcomes in patients with psoriasis-insights from a global registry-based study.

Mahil, Satveer K; Dand, Nick; Mason, Kayleigh J; Yiu, Zenas Z N; Tsakok, Teresa; Meynell, Freya; Coker, Bola; McAteer, Helen; Moorhead, Lucy; Mackenzie, Teena; Rossi, Maria Teresa; Rivera, Raquel; Mahe, Emmanuel; Carugno, Andrea; Magnano, Michela; Rech, Giulia; Balogh, Esther A; Feldman, Steven R; De La Cruz, Claudia; Choon, Siew Eng; ... (2021). Factors associated with adverse COVID-19 outcomes in patients with psoriasis-insights from a global registry-based study. Journal of allergy and clinical immunology, 147(1), pp. 60-71. Elsevier 10.1016/j.jaci.2020.10.007

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BACKGROUND

The multimorbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse outcomes of coronavirus disease 2019 (COVID-19), but the data are limited.

OBJECTIVE

Our aim was to characterize the course of COVID-19 in patients with psoriasis and identify factors associated with hospitalization.

METHODS

Clinicians reported patients with psoriasis with confirmed/suspected COVID-19 via an international registry, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 Infection. Multiple logistic regression was used to assess the association between clinical and/or demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviors.

RESULTS

Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% were receiving a nonbiologic, and 10% were not receiving any systemic treatment for psoriasis. In all, 348 patients (93%) were fully recovered from COVID-19, 77 (21%) were hospitalized, and 9 (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted odds ratio [OR] = 1.59 per 10 years; 95% CI = 1.19-2.13), male sex (OR = 2.51; 95% CI = 1.23-5.12), nonwhite ethnicity (OR = 3.15; 95% CI = 1.24-8.03), and comorbid chronic lung disease (OR = 3.87; 95% CI = 1.52-9.83). Hospitalization was more frequent in patients using nonbiologic systemic therapy than in those using biologics (OR = 2.84; 95% CI = 1.31-6.18). No significant differences were found between classes of biologics. Independent patient-reported data (n = 1626 across 48 countries) suggested lower levels of social isolation in individuals receiving nonbiologic systemic therapy than in those receiving biologics (OR = 0.68; 95% CI = 0.50-0.94).

CONCLUSION

In this international case series of patients with moderate-to-severe psoriasis, biologic use was associated with lower risk of COVID-19-related hospitalization than with use of nonbiologic systemic therapies; however, further investigation is warranted on account of potential selection bias and unmeasured confounding. Established risk factors (being older, being male, being of nonwhite ethnicity, and having comorbidities) were associated with higher hospitalization rates.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology

UniBE Contributor:

Naldi, Luigi

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1097-6825

Publisher:

Elsevier

Language:

English

Submitter:

Andrea Studer-Gauch

Date Deposited:

01 Feb 2022 14:23

Last Modified:

05 Dec 2022 16:03

Publisher DOI:

10.1016/j.jaci.2020.10.007

PubMed ID:

33075408

Uncontrolled Keywords:

COVID-19 biologics hospitalization immunosuppressants psoriasis risk factors

BORIS DOI:

10.48350/164286

URI:

https://boris.unibe.ch/id/eprint/164286

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