Management of patients with atopic dermatitis undergoing systemic therapy during COVID‐19 pandemic in Italy: Data from the DA‐COVID‐19 registry
Andrea Chiricozzi, Marina Talamonti, Clara De Simone, Marco Galluzzo, Niccolò Gori, Gabriella Fabbrocini, Angelo Valerio Marzano, Giampiero Girolomoni, Annamaria Offidani, Mariateresa Rossi, Luca Bianchi, Antonio Cristaudo, Maria Teresa Fierro, Luca Stingeni, Giovanni Pellacani, Giuseppe Argenziano, Annalisa Patrizi, Paolo D. Pigatto, Marco Romanelli, Paola Savoia, Pietro Rubegni, Caterina Foti, Nicola Milanesi, Anna Belloni Fortina, Maria Rita Bongiorno, Teresa Grieco, Sergio Di Nuzzo, Maria Concetta Fargnoli, Andrea Carugno, Alberico Motolese, Franco Rongioletti, Paolo Amerio, Riccardo Balestri, Concetta Potenza, Giuseppe Micali, Cataldo Patruno, Iris Zalaudek, M. Lombardo, Claudio Feliciani, Lucia Di Nardo, Fabrizio Guarneri, Ketty Peris, DA‐COVID‐19 study group
Abstract
BACKGROUND: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic. METHODS: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID-19 pandemic on the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were obtained at different timepoints by teledermatology during COVID-19 pandemic, when regular visits were not allowed due to sanitary restrictions. Disease severity was assessed by both physician- and patient-reported assessment scores evaluating itch intensity, sleep disturbances, and AD severity. RESULTS: A total of 1831 patients were included, with 1580/1831 (86.3%) continuing therapy during pandemic. Most patients were treated with dupilumab (86.1%, 1576/1831) that was interrupted in only 9.9% (156/1576) of cases, while systemic immunosuppressive compounds were more frequently withdrawn. Treatment interruption was due to decision of the patient, general practitioner, or dermatologist in 39.9% (114/286), 5.6% (16/286), and 30.1% (86/286) of cases, respectively. Fear of increased susceptibility to SARS-CoV-2 infection (24.8%, 71/286) was one of the main causes of interruption. Sixteen patients (0.9%) resulted positive to SARS-CoV-2 infection; 3 of them (0.2%) were hospitalized but no cases of COVID-related death occurred. CONCLUSIONS: Most AD patients continued systemic treatments during COVID pandemic and lockdown period, without high impact on disease control, particularly dupilumab-treated patients.