A large recent study found that people with psoriasis faced a slightly elevated risk of contracting COVID-19 -- but were not more susceptible to hospitalizations or death.
The study findings, published in the analyzed a study population covering 144,304 patients with psoriasis and an identical 144,304 control individuals. The mean (SD) age of study participants was 50.0 (20.5), 51.3% were females, and 83.0% were of Jewish ethnicity.
Ultimately, patients with psoriasis displayed a significantly higher risk of developing COVID-19 (adjusted HR 1.05; 95% CI 1.03-1.08; P<0.001). At the same time, however, patients with psoriasis had a comparable risk of COVID-19-associated hospitalization (HR 1.08; 95% CI 0.99-1.18; P=0.065) and mortality (HR 0.88; 95% CI 0.73-1.05; P=0.162) as their control-group counterparts.
The study was led by a team of researchers based in Israel. The following report excerpts were edited for length and clarity.
What were the key objectives of this investigation?
COVID-19 outcomes in patients with psoriasis remain somewhat mysterious. Scientific knowledge about the burden of COVID-19 on this patient group had been hindered to date by small studies and short follow-up durations.
Researchers aimed to evaluate the risk of COVID-19 infection itself, as well as associated hospitalization and mortality in patients with psoriasis. In addition, the team sought to identify determinants of COVID-19 complications in patients with psoriasis.
What were the study's main findings?
The findings suggested that although psoriasis imposes a slightly increased risk of contracting COVID-19 infection, it is not associated with increased vulnerability to the infection's complications.
With regard to those complications, patients with psoriasis displayed comparable risk of COVID-19-associated hospitalizations and associated mortality. In the psoriasis group, of the 14,449 patients who got infected, 232 (1.61%) died because of COVID-19. The corresponding figure in the control group was estimated at a statistically similar 1.68%.
Did researchers highlight any potential determinants of COVID-related hospitalization and mortality in people with psoriasis?
Yes. Determinants of COVID-19-associated hospitalization and mortality in patients with psoriasis were investigated. Among individuals hospitalized as a result of COVID-19, psoriasis patients were more likely to have type 2 diabetes mellitus (adjusted OR 1.24; 95% CI 1.03-1.50; P=0.027) and obesity (adjusted OR 1.37; 95% CI 1.13-1.65; P=0.001) relative to controls.
No major differences in demographic variables and comorbidities emerged in COVID-19 mortality between the psoriasis and control groups.
What are the clinical take-home messages?
Perhaps the study's top take-away message was the finding that patients with psoriasis are not predisposed to worse outcomes of COVID-19.
These findings are of particular importance given that some patients with psoriasis undergo immune-modulating therapy that could in theory render them more susceptible to infections, including COVID-19. Nevertheless, that difference did not materialize in this study.
Key findings
- COVID-19 infection risk slightly higher for people with psoriasis
- No significant differences in COVID-related hospitalization or death between psoriasis and control groups
- Obesity and diabetes identified as determinants of COVID-19 complications in people with psoriasis
Study co-author Arnon D. Cohen served as an advisor, investigator, or speaker for Abbvie, BI, Dexcel Pharma, Janssen, Novartis, Perrigo, Pfizer, and Rafa.
Primary Source
Journal of Cosmetic Dermatology
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