COVID-19 Complication Risk Low for Atopic Dermatitis Patients

The rate of COVID-19 complications is low for patients with atopic dermatitis, according to new research.

A team led by, A. H. Musters, Department of Dermatology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, identified COVID-19 outcomes for patients with atopic dermatitis treated with or without systematic immunomodulatory treatments.

A Lack of Data

There is not much data available on the effects of systemic immunomodulatory treatments on COVID-19 outcomes for patients with atopic dermatitis.

In the study, the investigators encouraged clinicians to report cases of COVID-19 in their patients with atopic dermatitis in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Atopic Dermatitis (SECURE-AD) registry between April 1, 2020 and October 31, 2021.

Overall, there were 442 patients with atopic dermatitis included in the study from 27 countries. The mean age was 35.9 years.

The data was analyzed using a multivariable logistic regression.

The investigators sought primary outcomes of hospitalization from COVID-19 according to atopic dermatitis treatment groups.

Severe COVID-19 Outcomes

Of the 442 patients with strongly suspected or confirmed COVID-19, 96.8% (n = 428) were treated with a single systemic therapy (n = 297; 67.2%) or topical therapy only (n = 131; 29.6%).

The majority of patients treated with systemic therapies were treated with dupilumab (n = 216), while 3.2% (n = 14) patients received a combination of systemic therapies. In addition, 5.9% (n = 26) of the patient population were hospitalized. However, there were no deaths reported.

Patients treated with topical medications also had significantly higher rates of hospitalization compared to patients treated with dupilumab monotherapy (OR, 4.65; 95% CI, 1.71-14.78), including after the investigators adjusted for confounding variables (aOR, 4.99; 95% CI, 1.4-20.84).

Combination systemic therapy, which did not include systemic corticosteroids, was linked to increased risk of hospitalization compared to single agent non-steroidal immunosuppressive systematic treatment (OR, 8.09; 95% CI, 0.4-59.96; aOR, 37.57; 95% CI, 1.05-871.11).

Patients treated with combination systemic therapy, which included corticosteroids were more likely to be hospitalized (OR, 40.43, 95% CI, 8.16-207.49; aOR, 45.75; 95% CI, 4.54-616.22).

“Overall, the risk of COVID-19 complications appears low in patients with AD, even when treated with systemic immunomodulatory agents,” the authors wrote. “Dupilumab monotherapy was associated with lower hospitalization than other therapies. Combination systemic treatment, particularly combinations including systemic corticosteroids, was associated with the highest risk of severe COVID-19.”

The study, “The effects of systemic immunomodulatory treatments on COVID-19 outcomes in patients with atopic dermatitis: results from the global SECURE-AD registry,” was published online in the Journal of the European Academy of Dermatology and Venereology.