Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Am J Clin Dermatol. 2021 Sep;22(5):709-718. doi: 10.1007/s40257-021-00605-8. Epub 2021 May 31.
The impact of immune-related conditions on the outcomes of coronavirus disease 2019 (COVID-19) is poorly understood. Determinants of COVID-19 outcomes among patients with psoriasis are yet to be established.
Th objective of this study was to characterize a large cohort of patients with psoriasis with COVID-19 and to identify predictors of COVID-19-associated hospitalization and mortality.
A population-based nested case-control study was performed using the computerized database of Clalit Health Services, Israel. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence (CIs) of predictors for COVID-19-associated hospitalization and mortality.
The study population included 3151 patients with psoriasis who tested positive for COVID-19. Subclinical COVID-19 infection occurred in 2818 (89.4%) of the patients while 122 (3.9%), 71 (2.3%), 123 (3.9%), and 16 (0.5%) of the patients experienced a mild, moderate, severe, and critical disease, respectively. Overall, 332 (10.5%) patients were hospitalized and 50 (1.6%) patients died because of COVID-19 complications. Intake of methotrexate independently predicted COVID-19-associated hospitalization (adjusted OR 2.30; 95% CI 1.11-4.78; p = 0.025). Use of biologic agents was not associated with COVID-19-associated hospitalization (OR 0.75; 95% CI 0.32-1.73; p = 0.491) or mortality (OR 0.85; 95% CI 0.12-6.21; p = 0.870). Older age, the presence of comorbid cardiovascular diseases, metabolic syndrome, chronic obstructive pulmonary disease, and chronic renal failure independently predicted both COVID-19-associated hospitalization and mortality.
The use of oral methotrexate was associated with an increased odds of COVID-associated hospitalization, whereas the use of biologic drugs was not associated with worse outcomes of COVID-19 among patients with psoriasis.
免疫相关疾病对 2019 年冠状病毒病（COVID-19）结局的影响尚未完全明确。银屑病患者 COVID-19 结局的决定因素仍有待确定。
本研究的目的是描述 COVID-19 患者的大型银屑病队列，并确定 COVID-19 相关住院和死亡的预测因素。
使用以色列 Clalit 健康服务的计算机数据库进行了一项基于人群的嵌套病例对照研究。多变量逻辑回归用于估计 COVID-19 相关住院和死亡的预测因素的比值比（OR）和 95%置信区间（CI）。
研究人群包括 3151 名 COVID-19 检测呈阳性的银屑病患者。2818 名（89.4%）患者发生亚临床 COVID-19 感染，122 名（3.9%）、71 名（2.3%）、123 名（3.9%）和 16 名（0.5%）患者分别患有轻度、中度、重度和危重症 COVID-19。总体而言，332 名（10.5%）患者因 COVID-19 并发症住院，50 名（1.6%）患者死亡。甲氨蝶呤的摄入独立预测 COVID-19 相关住院治疗（调整 OR 2.30；95%CI 1.11-4.78；p=0.025）。使用生物制剂与 COVID-19 相关住院治疗（OR 0.75；95%CI 0.32-1.73；p=0.491）或死亡（OR 0.85；95%CI 0.12-6.21；p=0.870）无关。年龄较大、合并心血管疾病、代谢综合征、慢性阻塞性肺疾病和慢性肾衰竭与 COVID-19 相关住院和死亡均独立相关。
口服甲氨蝶呤与 COVID 相关住院的几率增加相关，而生物药物的使用与银屑病患者 COVID-19 结局恶化无关。
