Patients with atopic dermatitis (AD), including those taking immunomodulatory therapies, did not have a significantly greater risk for severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection or hospitalization or death associated with the novel coronavirus compared with the general population, according to study data published in the British Journal of Dermatology.
This retrospective, cross-sectional study examined medical record data for 269,299 patients in the University of California COVID research data set. A total of 5387 patients in the cohort had AD. Patients in this data set were tested for SARS-CoV-2 from March 2020 to October 2020.
Of the 9808 patients who tested positive for SARS-Cov-2 in the overall cohort, 159 had AD. The infection rate was significantly lower among patients with AD vs those without the disease (2.95% vs 3.66%, respectively; P <.0063). The significantly lower rate of SARS-CoV-2 positivity was seen in women with AD (P =.0220) but not in men with AD (P =.1433).
In the AD cohort, there was a similar SARS-CoV-2 infection rate in patients taking vs not taking prednisone (2.58% vs 2.99%; P =.6210) and methotrexate (2.67% vs 2.96%; P =1.0).
No difference was observed between patients with AD vs those without AD in terms of the hospitalization rate associated with SARS-CoV-2 infection (13.8% vs 19.26%, respectively; P =.0851).
The mortality rate among SARS-CoV-2-positive patients in the overall cohort was higher among patients without AD (2.07% vs 1.89%). In regard to mortality, there was no significant difference between patients with AD taking prednisone and patients without AD.
Limitations of this study were the small sample size of participants on systemic drugs, the lack of patients taking dupilumab, and the use of data from a tertiary center.
The investigators concluded this study could be a logical step in understanding the “mechanisms underlying SARS- CoV-2 susceptibility,” which would be fundamental in the development of “better guidelines for populations at risk.”
Nguyen C, Yale K, Casale F, et al. SARS-CoV-2 infection in patients with atopic dermatitis: a cross-sectional study. Br J Dermatol. Published online May 6, 2021. doi:10.1111/bjd.20435