Atopic dermatitis associated with autoimmune, cardiovascular and mental health comorbidities: a systematic review and meta-analysis

Previous studies have reported conflicting estimates of associations between atopic dermatitis (AD) and autoimmune, cardiovascular and mental health comorbidities.Our objective was to determine and report these global associations based on a systematic literature review.A systematic search of studies published in PubMed/MEDLINE and Cochrane Library (January 1990 - April 2020) including patients with physician-diagnosed AD and concurrent populations, were identified. The metanalysis (random-effect model) included 37 studies. Studies originated from Europe, UK, Asia, The USA and Canada, including 237,226,993 patients and subjects with 20 autoimmune, eight cardiovascular and eight mental illnesses.Pooled analyses revealed significantly higher overall odds of autoimmune diseases (OR: 1.74; 95% CI: 1.55-1.94, p < 0.001; I2: 98.39%) and mental illnesses (OR: 1.62; 95% CI: 1.53-1.72; p < 0.001; I2: 98.86%) and a smaller increased risk for cardiovascular diseases (OR: 1.08; 95% CI: 0.01-1.16, p < 0.001; I2: 99.45%).Our systematic review highlights that AD patients are at significantly increased risk for many autoimmune diseases and mental illnesses and at a relatively lower risk for cardiovascular diseases. Updated global estimates should encourage physician/patient empowerment to seek further medical and wellness interventions for optimal patient care.