To assess the risk of hospitalization or in-hospital mortality due to COVID-19 by treatment exposure in psoriasis patients.
All adults with psoriasis registered in the French national health insurance (SNDS) database between 2008 and 2019 were eligible. Two study periods were considered: February 15 to June 30, 2020 and October 1, 2020 to January 31, 2021, first and second waves of COVID-19 pandemic in France respectively. Patients were classified according to their baseline treatment: biologics, non-biologics, topicals or no treatment. The primary endpoint was hospitalization for COVID-19 using Cox models with inverse probability of treatment weighting (IPTW). The secondary endpoint was in-hospital mortality due to COVID-19.
1,326,312 patients with psoriasis were identified (mean age: 59; men: 48%). During the first study period, 3,871 patients were hospitalized for COVID-19 and 759 (20%) died; 3,603 during the second period and 686 (19%) died. In the propensity score-weighted Cox models, risk of hospitalization for COVID-19 was associated with exposure to topicals or non-biologics (hazard ratio, 1.11; 95% confidence interval, 1.04–1.20 and 1.27; 1.09–1.48) 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.
Systemic treatments for psoriasis (including biologics) were not associated with increased risk of in-hospital mortality due to COVID-19. These results support the maintain of systemic treatment for psoriasis during the pandemic.
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