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中国一项回顾性、多中心队列研究:COVID-19 患者的银屑病临床特征和结局。

Clinical characteristics and outcomes of psoriasis patients with COVID-19: A retrospective, multicenter cohort study in China.

机构信息

Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China.

Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.

出版信息

Chin Med J (Engl). 2024 Jul 20;137(14):1736-1743. doi: 10.1097/CM9.0000000000003024. Epub 2024 May 6.

Abstract

BACKGROUND

Limited information exists regarding the impact of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection on psoriasis patients. The objective of this study was to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection.

METHODS

A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analyses were employed to identify factors associated with coronavirus disease 2019 (COVID-19)-related psoriasis outcomes. The study included 2371 psoriasis patients from 12 clinical centers, with 2049 of them having been infected with SARS-CoV-2.

RESULTS

Among the infected groups, lower exacerbation rates were observed in individuals treated with biologics compared to those receiving traditional systemic or nonsystemic treatments (22.3% [236/1058] vs . 39.8% [92/231] vs . 37.5% [140/373], P <0.001). Psoriasis progression with lesions (adjusted odds ratio [OR] = 8.197, 95% confidence interval [95% CI] = 5.685-11.820, compared to no lesions), hypertension (adjusted OR = 1.582, 95% CI = 1.068-2.343), traditional systemic (adjusted OR = 1.887, 95% CI = 1.263-2.818), and nonsystemic treatment (adjusted OR = 1.602, 95% CI = 1.117-2.297) were found to be associated with exacerbation of psoriasis after SARS-CoV-2 infection, but not biologics (adjusted OR = 0.931, 95% CI = 0.680-1.274, compared to no treatment), according to multivariable logistic regression analysis.

CONCLUSIONS

A reduced risk of psoriasis exacerbation after SARS-CoV-2 infection was observed with biologics compared to traditional systemic and nonsystemic treatments. Significant risk factors for exacerbation after infection were identified as existing psoriatic lesions and hypertension.

TRIAL REGISTRATION

ClinicalTrials.gov (No. NCT05961605).

摘要

背景

关于严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染对银屑病患者的影响,相关信息有限。本研究的目的是确定 SARS-CoV-2 感染后与银屑病预后相关的临床因素。

方法

这是一项于 2023 年 3 月至 5 月间进行的回顾性、多中心研究。采用单变量和多变量逻辑回归分析来确定与 COVID-19 相关的银屑病结局相关的因素。该研究纳入了来自 12 个临床中心的 2371 例银屑病患者,其中 2049 例感染了 SARS-CoV-2。

结果

在感染组中,与接受传统系统性或非系统性治疗的患者相比,接受生物制剂治疗的患者恶化率较低(22.3%[236/1058] vs. 39.8%[92/231] vs. 37.5%[140/373],P<0.001)。与无皮损相比,皮损存在(调整后的优势比[OR] = 8.197,95%置信区间[95%CI] = 5.685-11.820)、高血压(调整后的 OR = 1.582,95%CI = 1.068-2.343)、传统系统性治疗(调整后的 OR = 1.887,95%CI = 1.263-2.818)和非系统性治疗(调整后的 OR = 1.602,95%CI = 1.117-2.297)与 SARS-CoV-2 感染后的银屑病恶化相关,但生物制剂治疗(调整后的 OR = 0.931,95%CI = 0.680-1.274,与未治疗相比)无此关联,这是根据多变量逻辑回归分析得出的结果。

结论

与传统系统性和非系统性治疗相比,生物制剂治疗后 SARS-CoV-2 感染的银屑病恶化风险降低。感染后恶化的显著危险因素是存在银屑病皮损和高血压。

试验注册

ClinicalTrials.gov(编号:NCT05961605)。

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