(31) Risk of COVID-19 Among Patients with Atopic Dermatitis: A Targeted Literature Review

Publication Number: 362

Background: Atopic Dermatitis (AD) is a systemic inflammatory disorder that affects the skin and is associated with several comorbidities and other allergic conditions. Due to immune dysregulation in patients with AD and subsequent frequent use of immune modulating drugs, the dermatology community remains concerned about the risk of acquiring coronavirus disease-2019 (COVID-19) in individuals with AD.

Objectives: To report the incidence of COVID-19 among patients with AD by conducting a literature search.

Methods: A targeted literature search was conducted in PubMed and Embase through January 2022 for observational studies reporting the incidence of COVID-19 among the AD population of all severities and ages using search terms representative of AD and COVID-19. Case series, case reports, studies focused on COVID-19 incidence with the use of specific systemic drugs, and studies that report prevalence of AD in COVID-19 tested/positive population were excluded.

Results: The search yielded a total of 520 articles in both databases, of which six articles reported the incidence of COVID-19 in the AD population. The overall incidence of COVID-19 per 1000 AD patients ranged from 8.7 to 70.3 in registry-based studies while the incidence in population based (Claims/EHR) studies ranged from 41.8-46.3. Additionally, one study reported an increased risk (RR:1.18; 95%CI:1.12-1.24) of COVID-19 in AD patients compared to patients without AD. Of three studies that examined COVID-19 symptomology, 95.4% to 96.4% of the COVID-19 infected AD patients were either asymptomatic or had mild COVID-19 symptoms, and 3.5% to 4.6% of patients had moderate to severe COVID-19 symptoms.

Conclusions: The claims/EHR based studies reported similar estimates of incidence while the registry-based studies reported varying COVID-19 incidence estimates. These differences may be explained by the different countries in which they were conducted, the different study periods, and that one study was conducted in New York City, the epicenter of COVID-19 in the US at the time. The limited evidence available suggest, that the AD population may have a higher risk of acquiring COVID-19 infection, further research is needed to better understand the role of severity, treatment and other factors for the risk of COVID-19 among people with AD.