Desai Rini, Hashemzadeh Mehrtash, Tong Liliana, Olsen Rebecca, McCune Mariana, Irwin Chase, Davis Mitchell
College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, USA.
CHS Northwest Transitional Year Residency, Tucson, AZ, USA.
J Psoriasis Psoriatic Arthritis. 2025 May 15:24755303251342996. doi: 10.1177/24755303251342996.
Moderate to severe psoriasis is often treated with systemic medications, including traditional therapies (eg, methotrexate, cyclosporine) and biologics (eg, TNF inhibitors, IL-17 and IL-23 inhibitors). These immunomodulating treatments raise concerns about infection risks, particularly during the SARS-CoV-2 pandemic. However, literature on systemic therapy and COVID-19 outcomes in the United States is limited. This retrospective cohort study analyzed adults with psoriasis and a primary SARS-CoV-2 diagnosis from the 2020 Health care Cost and Utilization Project National Inpatient Sample database. Patients were stratified by systemic medication use, and propensity score matching adjusted for baseline comorbidities. Logistic regression and bivariate analyses assessed the association between systemic therapy and clinical outcomes, including medications and procedures for COVID-19 treatment, length of stay, and mortality. 721,870 patients were included after propensity score matching. Patients receiving systemic medications had higher odds of requiring supplemental oxygen (OR = 1.30; < .001) but lower odds of mechanical ventilation (OR = .76; < .001) and intubation (OR = .78; < .001). They also experienced shorter hospital stays (IRR = .982; < .001) and lower mortality (OR = .74; < .001). Systemic treatments for psoriasis influence COVID-19 outcomes, reducing the need for severe respiratory interventions, shortening hospitalization duration, and lowering mortality. These findings highlight the safety of systemic therapies, even during periods of heightened infection risk like the SARS-CoV-2 pandemic. Future research should investigate the differential effects of biologics and traditional therapies.
中度至重度银屑病通常采用全身用药治疗，包括传统疗法（如甲氨蝶呤、环孢素）和生物制剂（如肿瘤坏死因子抑制剂、白细胞介素-17和白细胞介素-23抑制剂）。这些免疫调节治疗引发了人们对感染风险的担忧，尤其是在新冠疫情期间。然而，美国关于全身治疗与新冠病毒感染结果的文献有限。这项回顾性队列研究分析了2020年医疗成本和利用项目全国住院患者样本数据库中患有银屑病且初次诊断为新冠病毒感染的成年人。患者根据全身用药情况进行分层，并采用倾向得分匹配法对基线合并症进行校正。逻辑回归和双变量分析评估了全身治疗与临床结果之间的关联，包括新冠病毒感染治疗的药物和程序、住院时间和死亡率。倾向得分匹配后纳入721,870名患者。接受全身用药的患者需要补充氧气的几率更高（比值比=1.30；P<0.001），但接受机械通气（比值比=0.76；P<0.001）和插管（比值比=0.78；P<0.001）的几率较低。他们的住院时间也较短（发病率比值=0.982；P<0.001），死亡率较低（比值比=0.74；P<0.001）。银屑病的全身治疗会影响新冠病毒感染的结果，减少对严重呼吸干预的需求，缩短住院时间，并降低死亡率。这些发现凸显了全身治疗的安全性，即使在像新冠疫情这样感染风险增加的时期也是如此。未来的研究应调查生物制剂和传统疗法的不同效果。
