Department of Medicine, Section of Dermatology and Venereology, University of Verona, Verona, Italy.
Department of Medicine, Section of Dermatology, University of Padua, Padua, Italy.
J Allergy Clin Immunol. 2021 Feb;147(2):558-560.e1. doi: 10.1016/j.jaci.2020.10.032. Epub 2020 Nov 5.
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.
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.
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.
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.
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.
生物制剂是否会增加 2019 年冠状病毒（COVID-19）的风险，或者影响慢性斑块状银屑病患者的疾病结局，仍有待确定。
我们旨在调查在接受生物疗法治疗的大量斑块状银屑病患者中，与普通人群相比，COVID-19 住院和死亡的发生率。
这是一项回顾性多中心队列研究，纳入了在意大利北部城市维罗纳、帕多瓦、维琴察、摩德纳、博洛尼亚、皮亚琴扎、都灵和米兰的多家主要医院皮肤科接受生物治疗并定期随访的慢性斑块状银屑病（n=6501）患者。在银屑病患者中估计每 10000 人月的住院和死亡发生率（精确的中位数 95%CI 和标准化发病率比），并与同一地理区域的普通人群进行比较。
COVID-19 住院的发生率在银屑病患者中为 11.7（95%CI，7.2-18.1）/10000 人月，在普通人群中为 14.4（95%CI，14.3-14.5）/10000 人月；COVID-19 死亡的发生率在银屑病患者中为 1.3（95%CI，0.2-4.3），在普通人群中为 4.7（95%CI，4.6-4.7）/10000 人月。与普通人群相比，银屑病患者的住院和死亡标准化发病率比分别为 0.94（95%CI，0.57-1.45；P=.82）和 0.42（95%CI，0.07-1.38；P=.19）。
我们的数据并未显示生物制剂对银屑病患者 COVID-19 结局有任何不利影响。我们不建议在已经接受治疗超过 6 个月且未感染严重急性呼吸综合征冠状病毒 2 的患者中停用生物制剂，以预防 COVID-19 住院和死亡。
