Incidence rates of hospitalization and death from COVID-19 in patients with psoriasis receiving biological treatment: a Northern Italy experience.

Abstract Introduction Whether biologic therapies enhance the risk of COVID-19 or affect the disease outcome in patients with chronic plaque psoriasis remains to be ascertained. Objective investigating the incidence of hospitalization and death for COVID-19 in a large sample of patients with plaque psoriasis receiving biologic therapies compared with the general population. Materials and methods This is a retrospective multicenter cohort study including patients with chronic plaque psoriasis (n=6,501) being treated with biologic therapy and regularly followed up at the Divisions of Dermatology of several main hospitals in the Northern Italian cities of Verona, Padua, Vicenza, Modena, Bologna, Piacenza, Turin, and Milan. Incidence rates (IR) of hospitalization and death per 10,000 person-months with exact mid-p 95% confidence intervals (CI) and standardized incidence ratios (SIR) were estimated in the psoriasis patients and compared with the general population in the same geographic areas. Results The IR of hospitalization for COVID-19 was 11.7 (95% CI: 7.2-18.1) per 10,000 person-months in psoriasis patients and 14.4 (95% CI: 14.3-14.5) in the general population; the IR of death from COVID-19 was 1.3 (95% CI: 0.2-4.3) and 4.7 (95% CI: 4.6-4.7) in psoriasis patients and the general population, respectively. The SIR of hospitalization and death in psoriasis patients compared with the general population was 0.94 (95% CI: 0.57-1.45; p=0.82) and 0.42 (95% CI: 0.07-1.38; p=0.19) respectively. Conclusions Our data did not show any adverse impact of biologics on COVID-19 outcome in psoriasis patients. We would not advise biologic discontinuation in patients on treatment since more than 6 months and not infected with SARS-CoV-2 to prevent hospitalization and death from COVID-19.