SARS‐CoV‐2 infection in patients with atopic dermatitis: a cross‐sectional study

Abstract

DEAR EDITOR, SARS-CoV-2 disproportionately impacts certain populations with inflammatory conditions that have an elevated risk of respiratory comorbidities. [1]2][3] Additionally, atopic dermatitis (AD) is associated with other atopic diseases, such as allergic rhinitis and asthma, which increase the risk of respiratory infections and predispose patients to neuropsychiatric disorders. 4 There are limited studies evaluating the role of systemic medications in risk of infection.However, recent studies postulated that systemic immunomodulatory and biologic treatments may protect patients from worsening SARS-CoV-2 outcomes. 5,6 In this study, we aimed to compare rates of SARS-CoV-2 infection, hospitalization and mortality among patients with or without AD in a California-based population.A retrospective cross-sectional study was conducted using the University of California COVID Research Data Set (UC CORDS), a Health Insurance Portability and Accountability Act secure medical records dataset for patients tested for SARS-CoV-2 across University of California medical centres. 7 Information regarding SARS-CoV-2 testing, patient demographics, hospitalization and mortality (from all causes, at any time after the positive test) was collected from 1 March 2020 to 8 October 2020.Patients with AD were diagnosed with 'atopic dermatitis' (International Classification of Diseases 10th Revision code L20Á9), 'acute dermatitis' (L30Á9), 'atopic neurodermatitis' (L20Á81), 'nummular eczema' (L30Á0) or 'flexural eczema' (L20Á82) by a dermatologist or primary care provider.Specific systemic treatment subgroups were identified (prednisone, methotrexate, ciclosporin or dupilumab) for at least 30 days prior to SARS-CoV-2 testing.Fisher exact and v 2 -tests were used for statistical analysis.In total 269 299 patients were tested within the UC CORDS, with a 3Á64% positive test rate (n = 9808, average age 42 years) (Table 1).Of these, 5387 patients with AD were tested for SARS-CoV-2 and had a 2Á95% (n = 159, average age 34 years) infection rate, which was lower than in those without AD (3Á66%, n = 9649, average age 42 years) (P = 0Á0063).This observation was significant in women with AD compared with those without (2Á7% vs. 3Á46%, P = 0Á022), but was not significant in men (3Á3% vs. 3Á89%, P = 0Á14).There were similar proportions of COVID-19-positive men with and without AD (49% vs. 47%, P = 0Á70).

Topics & Concepts