COVID-19
Incidence rates of hospitalization and death from COVID-19 in patients with psoriasis receiving biological treatment: A Northern Italy experience

https://doi.org/10.1016/j.jaci.2020.10.032Get rights and content

Introduction

Whether biologic therapies enhance the risk of coronavirus 2019 (COVID-19) or affect the disease outcome in patients with chronic plaque psoriasis remains to be ascertained.

Objective

We sought to investigate the incidence of hospitalization and death for COVID-19 in a large sample of patients with plaque psoriasis receiving biologic therapies compared with the general population.

Methods

This is a retrospective multicenter cohort study including patients with chronic plaque psoriasis (n = 6501) being treated with biologic therapy and regularly followed up at the divisions of dermatology of several main hospitals in the Northern Italian cities of Verona, Padua, Vicenza, Modena, Bologna, Piacenza, Turin, and Milan. Incidence rates of hospitalization and death per 10,000 person-months with exact mid-p 95% CIs and standardized incidence ratios were estimated in the patients with psoriasis and compared with those in the general population in the same geographic areas.

Results

The incidence rate of hospitalization for COVID-19 was 11.7 (95% CI, 7.2-18.1) per 10,000 person-months in patients with psoriasis and 14.4 (95% CI, 14.3-14.5) in the general population; the incidence rate of death from COVID-19 was 1.3 (95% CI, 0.2-4.3) and 4.7 (95% CI, 4.6-4.7) in patients with psoriasis and the general population, respectively. The standardized incidence ratio of hospitalization and death in patients with psoriasis compared with those in the general population was 0.94 (95% CI, 0.57-1.45; P = .82) and 0.42 (95% CI, 0.07-1.38; P = .19), respectively.

Conclusions

Our data did not show any adverse impact of biologics on COVID-19 outcome in patients with psoriasis. We would not advise biologic discontinuation in patients on treatment since more than 6 months and not infected with severe acute respiratory syndrome coronavirus 2 to prevent hospitalization and death from COVID-19.

Key words

Psoriasis
biologics
COVID-19
interstitial pneumonia

Abbreviations used

COVID-19
Coronavirus 2019
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
SIR
Standardized incidence ratio

Cited by (0)

Supported by Fondazione Cariplo, Fondazione Veronesi, Impact of COVID19 infection on patients affected by inflammatory skin diseases on immuno-suppressive therapies (COVISKIN); ID 1833073 rif. 2020-1363.

Disclosure of potential conflict of interest: P. Gisondi has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEO Pharma, Eli Lilly, Novartis, Pierre Fabre, Pfizer, Sandoz, and UCB. S. Piaserico has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEO Pharma, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Sandoz, and UCB. L. Naldi has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Janssen, Eli Lilly, and Novartis. P. Dapavo has been a consultant and/or speaker for Abbvie, Amgen-, LEO Pharma, Eli Lilly, Novartis, and UCB. A. Conti has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Eli Lilly, Janssen, LEO Pharma, Novartis, and UCB. P. Malagoli has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Genzyme, Janssen, LEO Pharma, Eli Lilly, Novartis, Sanofi, UCB, and Pierre Fabre. F. Bardazzi has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEO Pharma, Eli Lilly, Novartis, Pfizer, Sandoz, and UCB. A. Costanzo has been a consultant and/or speaker for Abbvie, Almirall, Amgen, Janssen, LEOPharma, Eli Lilly, Novartis, Pfizer, Sandoz, and UCB. The rest of the authors declare that they have no relevant conflicts of interest.

These authors contributed equally to this work.

Collaborators in the studies of COVID-19 pandemic: Lidia Sacchelli, Elena Pezzolo, Francesco Messina, Claudia Lasagni, Laura Bigi, Angelo Cattaneo, Carlo Giovanni Carrera, Luisa Arancio, Simone Ribero, Giulia Rozzo, Giovanni Damiani, and Paola Facheris.

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