There is no indication that certain patients with psoriasis or patients who have received a renal transplant are at increased risk for hospitalization or death from coronavirus disease 2019 (COVID-19), finds study data published in the Journal of the American Academy of Dermatology. This is despite a patient population who were immunocompromised as a result of medication and of older age and likely possessing metabolic and cardiovascular comorbidities.

From February 20 to April 10, 2020, researchers conducted a retrospective, observational study with the aim of determining if patients of Verona, Italy, with chronic plaque psoriasis receiving biologic or other immunosuppressive therapies as well as those who has received renal transplantation had a greater risk for hospitalization or death from COVID-19 than the general population of the city.

The investigators extracted data from hospital electronic medical records of patients with psoriasis receiving biologic or other immunosuppressive therapies and patients who had received renal transplantation. The data were then compared with the records from the general population of Verona (n=257,353) provided by the national public database.

At study conclusion, 1.2% (n=3199) of the population of Verona were COVID-19 positive; this percentage included patients who survived COVID-19 and those who did not require hospitalization. Results demonstrated that none of the 980 patients with chronic plaque psoriasis receiving biologic agents were hospitalized and none died. The researchers noted that of the 243 patients who had received renal transplantation, 1 patient was admitted to hospital for fever and pneumonia but fully recovered. Patients with psoriasis receiving biologic therapy and those who had received a renal transplant demonstrated a higher prevalence of obesity, hypertension, diabetes, and history of cardiovascular disease, the study data revealed. These patients also tended to be older and were predominantly men, compared with the general population.

The absence of molecular or serological testing for COVID-19 in the study population, the considerable difference in patient sample size and that of the general population cohort, and the small number of hospitalizations and deaths in the patient group were cited by the researchers as limitations of the study. However, because the authors had access to the complete medical record for all members of the patient group, a notable strength of the study was that if there had been a case of hospitalization or death from COVID-19, it would have been detected.

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Reference

Gisondi P, Zaza G, Del Giglio M, Rossi M, Iacono V, Girolomoni G . Risk of hospitalization and death from COVID-19 infection in patients with chronic plaque psoriasis receiving a biological treatment and renal transplanted recipients in maintenance immunosuppressive treatment [published online April 21, 2020]. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.04.085

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Biologic, Immunosuppressive Therapies Not Tied to Severe Outcomes From COVID-19 Infection - Dermatology Advisor