Clinical characteristics and outcomes of psoriasis patients with COVID-19: a retrospective, multicenter cohort study in China

Abstract Objective and design Limited information is available on the impact of SARS-CoV-2 infection in psoriasis patients, and we aim to identify clinical factors associated with the prognosis of psoriasis following SARS-CoV-2 infection. Subjects and methods A retrospective, multicenter study was conducted between March and May 2023. Univariable and multivariable logistic regression analysis were employed to identify factors associated with COVID-19-related psoriasis outcomes. A total of 2371 psoriasis patients from 12 clinical centers were included in the study, with 2049 of them being infected with COVID-19. Results Among the infected group, individuals treated with biologics exhibited lower exacerbation rates compared to those receiving traditional systemic or non-systemic treatments (26.7% vs. 39.8% vs. 37.5%, P <0.001). Multivariable logistic regression analysis revealed that psoriasis progression with lesions (adjusted odds ratio[OR]=8.197, 95% confidence interval[CI]=5.685-11.820, compared to no lesions), hypertension (adjusted OR=1.582, 95%CI=1.068-2.343), traditional systemic (adjusted OR=1.887, 95%CI=1.263-2.818), and non-systemic treatment (adjusted OR=1.602, 95%CI=1.117-2.297) were associated with exacerbation of psoriasis after SARS-CoV-2 infection but not biologics (adjusted OR=0.931, 95%CI =0.680-1.274, compared to no treatment). Conclusions Biologics may reduce the risk of psoriasis exacerbation after SARS-CoV-2 infection, compared to traditional systemic and non-systemic treatments. The presence of existing psoriatic lesions and hypertension have been identified as significant risk factors for exacerbation after infection.