Factors associated with adverse COVID-19 outcomes in patients with psoriasis-insights from a global registry-based study.
COVID-19
biologics
hospitalization
immunosuppressants
psoriasis
risk factors
Journal
The Journal of allergy and clinical immunology
ISSN: 1097-6825
Titre abrégé: J Allergy Clin Immunol
Pays: United States
ID NLM: 1275002
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
10
07
2020
revised:
01
10
2020
accepted:
08
10
2020
pubmed:
20
10
2020
medline:
16
1
2021
entrez:
19
10
2020
Statut:
ppublish
Résumé
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. Our aim was to characterize the course of COVID-19 in patients with psoriasis and identify factors associated with hospitalization. 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 33075408
pii: S0091-6749(20)31413-5
doi: 10.1016/j.jaci.2020.10.007
pmc: PMC7566694
pii:
doi:
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
60-71Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 205039/Z/16/Z
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/S003126/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/T02383X/1
Pays : United Kingdom
Investigateurs
Aadarsh Shah
(A)
Alberto Barea
(A)
Alberto Romero-Maté
(A)
Alekya Singapore
(A)
Alexandra Paolino
(A)
Alice Mwale
(A)
Ana Maria Morales Callaghan
(AM)
Ana Martinez
(A)
Andrew DeCrescenzo
(A)
Andrew E Pink
(AE)
Ann Jones
(A)
Ann Sergeant
(A)
Annette Essex
(A)
Anthony Bewley
(A)
Areti Makrygeorgou
(A)
Astrid van Huizen
(A)
Beatriz Pérez-Suárez
(B)
Benhadou Farida
(B)
Birgitta Wilson Claréus
(BW)
Carla Tubau Prims
(CT)
Carrie Davis
(C)
Catherine Quinlan
(C)
Catriona Maybury
(C)
Gonzalez A Cesar
(GA)
Charlotte Barclay
(C)
Claudio Greco
(C)
Danielle Brassard
(D)
Deanna Cummings
(D)
Deepti Kolli
(D)
Vincent Descamps
(V)
Diana Ruiz Genao
(DR)
Efrossini Carras
(E)
Elena Hawryluk
(E)
Eliseo Martínez-García
(E)
Elzbieta Klujszo
(E)
Emily Dwyer
(E)
Emmanuel Toni
(E)
Enikö Sonkoly
(E)
Enrique Loayza
(E)
Esteban Daudén
(E)
Fernando Valenzuela
(F)
Georgi Popov
(G)
Georgie King
(G)
Girard Celine
(G)
Gloria Aparicio
(G)
Graham A Johnston
(GA)
Gustavo Anibal Cardozo
(GA)
Ian Pearson
(I)
Ignacio Yanguas
(I)
Jamie Weisman
(J)
Jennifer E Carolan
(JE)
Jenny Hughes
(J)
Jose-Maria Ortiz-Salvador
(JM)
Jose-Manuel Carrascosa
(JM)
Joseph J Schwartz
(JJ)
Karina Jackson
(K)
Kathryn G Kerisit
(KG)
Keith Wu
(K)
Leila Asfour
(L)
Leontien de Graaf
(L)
Cécile Lesort
(C)
Lieve Meuleman
(L)
Liv Eidsmo
(L)
Lone Skov
(L)
Lorraine Gribben
(L)
Malcolm Rustin
(M)
Manel Velasco
(M)
Manisha Panchal
(M)
Manpreet Lakhan
(M)
Manuel D Franco
(MD)
Marie-Louise Svensson
(ML)
Mark Vandaele
(M)
Maruska Marovt
(M)
Omid Zargari
(O)
Pablo De Caso
(P)
Paulo Varela
(P)
Peter Jenkin
(P)
Céline Phan
(C)
Philip Hampton
(P)
Portia Goldsmith
(P)
Rachel Bak
(R)
Reinhart Speeckaert
(R)
Ricardo Romiti
(R)
Richard Woolf
(R)
Rogelio Mercado-Seda
(R)
Rohima Khatun
(R)
Romana Ceovic
(R)
Rosa Taberner
(R)
Russell W Cohen
(RW)
Simina Stefanescu
(S)
Sarah Kirk
(S)
Saskia Reeken
(S)
Shanti Ayob
(S)
Silvia Pérez-Barrio
(S)
Stefano Piaserico
(S)
Susannah Hoey
(S)
Tiago Torres
(T)
Toomas Talme
(T)
Trupti V Desai
(TV)
Adrienne J van Geest
(AJ)
Victoria King
(V)
Vito Di Lernia
(V)
Zahira Koreja
(Z)
Vito Zeeshaan Hasab
(VZ)
Informations de copyright
Copyright © 2020. Published by Elsevier Inc.
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