Characteristic of chronic plaque psoriasis patients treated with biologics in Italy during the COVID-19 Pandemic: Risk analysis from the PSO-BIO-COVID observational study

ABSTRACT

Background: The susceptibility of patients with chronic plaque psoriasis and the risks or benefits related to the use of biological therapies for COVID-19 are unknown.

Few data about prevalence, clinical course and outcomes of COVID-19 among psoriatic patients were reported. The aims of this study were 1) to assess the prevalence and severity of COVID-19 in psoriatic patients treated with biologic agents during the first phase of the emergency (22 February to 22 April 2020) in Italy, and 2) to report the clinical outcomes of patients who have been exposed to individuals with confirmed SARS-CoV-2 infection.

Methods: Patients with moderate-to-severe chronic plaque psoriasis, aged ≥18 years and undergoing treatment with biologic agents as of 22 February 2020, were eligible to be included in PSO-BIO-COVID study. Demographic and clinical characteristics of patients using any biologic for psoriasis treatment between 22 February and 22 April 2020 were registered.

Results: A total of 12,807 psoriatic patients were included in the PSO-BIO-COVID study.

In this cohort 26 patients (0.2%) had a swab confirmation of SARS-CoV-2 infection. Eleven patients required hospitalization and two died.

Conclusion: The incidence of COVID-19 observed in our cohort of psoriatic patients (0.2%) is similar to that seen in the general population (0.31%) in Italy. However, the course of the disease was mild in most patients. Biological therapies may likely lessen ‘cytokine storm’ of COVID-19, which sometimes lead to multiple organ failure, ARDS, and death.

KEYWORDS:

• COVID-19
• psoriasis
• biological therapy
• dermatology
• sars-CoV-2

Author contributions

MT, MG, AC, LB, KP were involved in the conception and design of the study; MT, MG, AC, LB, KP, PQ, GF, PG, AVM, CP, AC, AP, SP, FB, GA, FR, LS, GM, FL, MTR, MRB, CF, PR, PA, MCF, PP, PS, SPN, SG, AC, SPC, GR, FP, AO, ML, IZ and PSO-BIO-COVID study group recruited patients and data acquisition; MG, MT, LB, AC, KP were involved in the analysis and interpretation of the data; all authors contributed to drafting the paper/revising it critically for intellectual content and approved the final version of the manuscript to be published.

Declaration of interest

L Bianchi reports personal fees from speaker and as consultant for Abbvie, Novartis, Janssen-Cilag, Pfizer, UCB, and Leo-Pharma, outside the submitted work. SP Cannavò has served as speaker or board member for Abbvie, Celgene, Eli-Lilly, Leo Pharma, Janssen, Novartis, Sanofi-Genzyme. A Chiricozzi served as advisory board member and consultant and has received fees and speaker’s honoraria or has participated in clinical trials for Abbvie, Almirall, Biogen, Fresenius Kabi, Leo Pharma, Lilly, Janssen, Novartis, Sanofi Genzyme, and UCB-Pharma. A Conti served as advisory board member and consultant, and has received fees and speaker’s honoraria or has participated in clinical trials for Abbvie, Leo Pharma, Eli Lilly, Novartis, UCB-Pharma, Pfizer, Sandoz, Celgene, Biogen and Janssen Cilag. MC Fargnoli has served on advisory boards, received honoraria for lectures and research grants from Almirall, Abbvie, Galderma, Leo Pharma, Mylan, Medac Pharma, Celgene, Pierre Fabre, UCB, Eli Lilly, Pfizer, Janssen, Novartis, Sanofi-Genzyme, Roche, Sunpharma, and MSD. P Gisondi has been a consultant and/or speaker for Abbvie, Almirall, Celgene, Janssen, Leo-pharma, Eli Lilly, Novartis, Pfizer, Sandoz, UCB. K Peris reports personal fees for advisory board meeting from Almirall, AbbVie, Biogen, Janssen, Eli Lilly, Celgene, Galderma, Leo Pharma, Novartis, Pierre Fabre, Sanofi, Sandoz, and Sun Pharma outside the conduct of the work. S Piaserico has been a consultant and/or speaker for Abbvie, Almirall, Celgene, Janssen, Leo-pharma, Eli Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Sandoz, and UCB. I Zalaudek has been a consultant and/or speaker for Novartis, Celgene, Amgen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

IRB approval status

Reviewed and approved by the National Ethics Committee of the National Institute for Infectious Diseases Lazzaro Spallanzani in Rome (Approval No. 138).

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.