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2. Factors associated with adverse COVID-19 outcomes in patients with psoriasis—insights from a global registry–based study
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Silvia Pérez-Barrio, Lucy Moorhead, Manpreet Lakhan, Saskia Reeken, Vito Zeeshaan Hasab, Rogelio Mercado-Seda, Gustavo Anibal Cardozo, Georgi Popov, Enrique Loayza, Marie-Louise Svensson, Emmanuel Mahe, Fernando Valenzuela, Victoria King, Michela Magnano, Danielle Brassard, Annette Essex, Deanna Cummings, Manisha Panchal, Trupti V. Desai, Jennifer E. Carolan, Areti Makrygeorgou, Zenas Z N Yiu, Teena Mackenzie, Esteban Daudén, Emmanuel Toni, Ian Pearson, Andrea Carugno, Lorraine Gribben, Leontien de Graaf, Liv Eidsmo, Esther A. Balogh, Gloria Aparicio, Andrew Pink, Manel Velasco, Adrienne J. van Geest, Steven R. Feldman, Tiago Torres, Elzbieta Klujszo, Malcolm H.A. Rustin, Ignacio Yanguas, Anthony Bewley, Eliseo Martínez-García, Benhadou Farida, Emily Dwyer, Susannah Hoey, Richard B. Warren, Esther E. Freeman, Diana Ruiz Genao, Rohima Khatun, Giulia Rech, Elena B. Hawryluk, Zahira Koreja, Ricardo Romiti, Gonzalez A. Cesar, Alice Mwale, Charlotte Barclay, Aadarsh Shah, Catherine Quinlan, Kathryn G. Kerisit, Christopher E.M. Griffiths, Carla Tubau Prims, Lone Skov, Céline Phan, Vincent Descamps, Jenny Hughes, Siew Eng Choon, Shanti Ayob, Efrossini Carras, Girard Celine, Jo Lambert, Alberto Barea, Jonathan Barker, Reinhart Speeckaert, Raquel Rivera, Portia Goldsmith, Nick Dand, Beatriz Pérez-Suárez, Andrew DeCrescenzo, F. Meynell, Francesca Capon, Toomas Talme, Teresa Tsakok, Deepti Kolli, Stefano Piaserico, Jamie Weisman, Manuel D. Franco, K.J. Mason, Pablo De Caso, Catriona Maybury, Rachel Bak, Ann Sergeant, Keith Wu, Graham A. Johnston, Alexandra Paolino, Cécile Lesort, Mark Vandaele, H. McAteer, Birgitta Wilson Claréus, Sinead Langan, Jose-Manuel Carrascosa, Enikö Sonkoly, Claudia de la Cruz, Maruska Marovt, Luigi Naldi, Leila Asfour, Paola Di Meglio, Jose-Maria Ortiz-Salvador, Alekya Singapore, Peter Jenkin, Romana Ceovic, R. Taberner, P.J. Hampton, Alberto Romero-Maté, Russell W. Cohen, Omid Zargari, Maria Teresa Rossi, Devon E. McMahon, Denis Jullien, Bola Coker, Carrie Davis, Georgie King, Catherine H. Smith, Richard Woolf, Luis Puig, Ann Jones, Astrid van Huizen, Joseph J. Schwartz, Paolo Gisondi, Phyllis I. Spuls, Satveer K. Mahil, Sarah Kirk, Paulo Varela, K. Jackson, Ana Maria Morales Callaghan, Vito Di Lernia, Lieve Meuleman, Claudio Greco, Simina Stefanescu, Hervé Bachelez, Ana Martinez, Dermatology, AII - Inflammatory diseases, APH - Methodology, APH - Quality of Care, Mahil, S, Dand, N, Mason, K, Yiu, Z, Tsakok, T, Meynell, F, Coker, B, Mcateer, H, Moorhead, L, Mackenzie, T, Rossi, M, Rivera, R, Mahe, E, Carugno, A, Magnano, M, Rech, G, Balogh, E, Feldman, S, De La Cruz, C, Choon, S, Naldi, L, Lambert, J, Spuls, P, Jullien, D, Bachelez, H, Mcmahon, D, Freeman, E, Gisondi, P, Puig, L, Warren, R, Di Meglio, P, Langan, S, Capon, F, Griffiths, C, Barker, J, Smith, C, Shah, A, Barea, A, Romero-Mate, A, Singapore, A, Paolino, A, Mwale, A, Morales Callaghan, A, Martinez, A, Decrescenzo, A, Pink, A, Jones, A, Sergeant, A, Essex, A, Bewley, A, Makrygeorgou, A, van Huizen, A, Perez-Suarez, B, Farida, B, Clareus, B, Prims, C, Davis, C, Quinlan, C, Maybury, C, Cesar, G, Barclay, C, Greco, C, Brassard, D, Cummings, D, Kolli, D, Descamps, V, Genao, D, Carras, E, Hawryluk, E, Martinez-Garcia, E, Klujszo, E, Dwyer, E, Toni, E, Sonkoly, E, Loayza, E, Dauden, E, Valenzuela, F, Popov, G, King, G, Celine, G, Aparicio, G, Johnston, G, Cardozo, G, Pearson, I, Yanguas, I, Weisman, J, Carolan, J, Hughes, J, Ortiz-Salvador, J, Carrascosa, J, Schwartz, J, Jackson, K, Kerisit, K, Wu, K, Asfour, L, de Graaf, L, Lesort, C, Meuleman, L, Eidsmo, L, Skov, L, Gribben, L, Rustin, M, Velasco, M, Panchal, M, Lakhan, M, Franco, M, Svensson, M, Vandaele, M, Marovt, M, Zargari, O, De Caso, P, Varela, P, Jenkin, P, Phan, C, Hampton, P, Goldsmith, P, Bak, R, Speeckaert, R, Romiti, R, Woolf, R, Mercado-Seda, R, Khatun, R, Ceovic, R, Taberner, R, Cohen, R, Stefanescu, S, Kirk, S, Reeken, S, Ayob, S, Perez-Barrio, S, Piaserico, S, Hoey, S, Torres, T, Talme, T, Desai, T, van Geest, A, King, V, Di Lernia, V, Koreja, Z, and Hasab, V
- Subjects
Male ,IMID, immune-mediated inflammatory disease ,immunosuppressant ,BMI, body mass index ,ACEi, angiotensin-converting enzyme inhibitor ,PsoProtect, Psoriasis Patient Registry for Outcomes, Therapy and Epidemiology of COVID-19 infecTion ,Logistic regression ,Systemic therapy ,030207 dermatology & venereal diseases ,0302 clinical medicine ,RC705 ,Interquartile range ,COVID-19 ,biologics ,hospitalization ,immunosuppressants ,psoriasis ,risk factors ,Risk Factors ,Epidemiology ,Immunology and Allergy ,030212 general & internal medicine ,Registries ,NSAID, non-steroidal anti-inflammatory drug ,610 Medicine & health ,COVID-19, Coronavirus disease 2019 ,TNF, tumor necrosis factor ,Age Factors ,Middle Aged ,Hospitalization ,risk factor ,95% CI, 95% confidence interval ,Female ,JAK, Janus kinase ,biologic ,Adult ,medicine.medical_specialty ,Immunology ,Lower risk ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,Article ,03 medical and health sciences ,Sex Factors ,Internal medicine ,Psoriasis ,medicine ,Humans ,SARS-CoV-2 ,IFN, interferon ,IQR, interquartile range ,psoriasi ,business.industry ,Odds ratio ,medicine.disease ,ARB, angiotensin II receptor blocker ,IL, interleukin ,OR, odds ratio ,business ,Body mass index - Abstract
Background The multi-morbid burden and use of systemic immunosuppressants in people with psoriasis may confer greater risk of adverse COVID-19 outcomes but data are limited. Objective Characterize the course of COVID-19 in psoriasis and identify factors associated with hospitalization. Methods Clinicians reported psoriasis patients with confirmed/suspected COVID-19 via an international registry, PsoProtect. Multiple logistic regression assessed the association between clinical/demographic characteristics and hospitalization. A separate patient-facing registry characterized risk-mitigating behaviours. Results Of 374 clinician-reported patients from 25 countries, 71% were receiving a biologic, 18% a non-biologic and 10% no systemic treatment for psoriasis. 348 (93%) fully recovered from COVID-19, 77 (21%) were hospitalized and nine (2%) died. Increased hospitalization risk was associated with older age (multivariable-adjusted OR 1.59 per 10 years, 95% CI 1.19-2.13), male sex (OR 2.51, 95% CI 1.23-5.12), non-white 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 non-biologic systemic therapy than biologics (OR 2.84, 95% CI 1.31-6.18). No significant differences were found between biologic classes. Independent patient-reported data (n=1,626 across 48 countries) suggested lower levels of social isolation in individuals receiving non-biologic systemic therapy compared to biologics (OR 0.68, 95% CI 0.50-0.94). Conclusion In this international moderate-severe psoriasis case series, biologics use was associated with lower risk of COVID-19-related hospitalization than non-biologic systemic therapies, however further investigation is warranted due to potential selection bias and unmeasured confounding. Established risk factors (being older, male, non-white ethnicity, comorbidities) were associated with higher hospitalization rates. Clinical Implications We identify risk factors for COVID-19-related hospitalization in psoriasis patients, including older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic therapies., Capsule summary: In this global registry-based study, risk factors for COVID-19-related hospitalization in psoriasis patients were older age, male sex, non-white ethnicity and comorbidities. Use of biologics was associated with lower hospitalization risk than non-biologic systemic treatment.
- Published
- 2021
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