Psoriasis-related treatment exposure and hospitalization or in-hospital mortality due to COVID-19 during the first and second wave of the pandemic: cohort study of 1 326 312 patients in France.

Abstract

SummaryBackgroundData on treatment exposures for psoriasis and poor COVID‐19 outcomes are limited.ObjectivesTo assess the risk of hospitalization or in‐hospital mortality due to COVID‐19 by treatment exposure in patients with psoriasis.MethodsAll adults with psoriasis registered in the French national health‐insurance (Système National des Données de Santé, SNDS) database between 2008 and 2019 were eligible. Two study periods were considered: 15 February to 30 June 2020 and 1 October 2020 to 31 January 2021, the first and second waves of the COVID‐19 pandemic in France, respectively. Patients were classified according to their baseline treatment: biologics, nonbiologics, topicals or no treatment. The primary endpoint was hospitalization for COVID‐19 using Cox models with inverse probability of treatment weighting. The secondary endpoint was in‐hospital mortality due to COVID‐19.ResultsWe identified 1 326 312 patients with psoriasis (mean age 59 years; males, 48%). During the first study period, 3871 patients were hospitalized for COVID‐19 and 759 (20%) died; during the second period 3603 were hospitalized for COVID‐19 and 686 (19%) died. In the propensity score‐weighted Cox models, risk of hospitalization for COVID‐19 was associated with exposure to topicals or nonbiologics [hazard ratio (95% confidence interval): 1·11 (1·04–1·20) and 1·27 (1·09–1·48), respectively] during the first period, and with all exposure types, during the second period. None of the exposure types was associated with in‐hospital mortality due to COVID‐19.ConclusionsSystemic treatments for psoriasis (including biologics) were not associated with increased risk of in‐hospital mortality due to COVID‐19. These results support maintaining systemic treatment for psoriasis during the pandemic.