• New research analyzed COVID-19 outcomes in 1.3 million people with psoriasis who were using different forms of treatment.
• Researchers concluded that psoriasis treatments may increase a person’s risk of hospitalization due to COVID-19, but they do not make a person more likely to die from the diseases.

Since the start of the COVID-19 pandemic, people with psoriasis and health care providers alike have had concerns as to whether psoriasis treatments could affect COVID-19 outcomes. In a new study, researchers in France found that all types of psoriasis treatments, including biologics, did not increase a person’s chances of dying from COVID-19.

“These results suggest that systemic treatments for patients with psoriasis should be continued during the pandemic,” according to a summary of the research from the British Journal of Dermatology.

The study authors looked at the effects of three different types of treatments. They found that topical medications, including lotions or creams applied to the skin, did not have large effects on immunity (the ability to fight off infections). The other two main treatment categories covered medications designed to lessen the strength of the immune system: biologics (drugs that block a specific part of the immune system) and nonbiologics (other oral medications that work in different ways to suppress immune cells).

Psoriasis Treatments Don’t Increase COVID-19 Deaths

In the study, researchers included more than 1.3 million adults with psoriasis. The researchers studied whether these people visited the hospital due to COVID-19 during two different time periods, which correlated with the first two large waves of COVID-19 infections in France. Both waves occurred before vaccines were widely available, or available at all.

During the first wave, from February 15 through June 15, 2020, more than 3,800 people among the pool of 1.3 million were hospitalized with COVID-19. Twenty percent of those who were hospitalized died. The second wave, which took place between October 1 and December 31, 2020, left 3,600 people in the hospital. About 19 percent of this group died.

When the researchers compared death rates among people using different types of psoriasis treatments, they found no differences. “There is no increased risk of mortality from COVID whatever the underlying treatment for psoriasis is. This is the most important point,” said Dr. Emilie Sbidian, senior author of the study.

Treatments May Raise Risk of Hospitalization

The researchers also examined how often people were hospitalized during these time periods. They found:

• In the first wave, people with psoriasis who used topical medications were 11 percent more likely to be hospitalized following a COVID-19 infection. During the second time period, people who used topical medications were 17 percent more likely to be admitted to the hospital.
• Those who used nonbiologic treatments were 27 percent more likely to be hospitalized during the first wave. This risk increased to 45 percent in the second wave.
• During the first wave, people who used biologics were not more likely to be hospitalized. In the following time period, those who used biologics were 44 percent more likely to go to the hospital following an infection.

Although more people using psoriasis treatments needed to go to the hospital, the study authors did not believe that this meant that their infections were worse. “Our hypothesis is that this excess risk of hospitalization is related to the characteristics of the patients (comorbidities plus systemic treatment) rather than the severity of COVID infection,” Dr. Sbidian said.

Because of uncertainties surrounding treatments that affect the immune system, 60 percent fewer people started using biologics during the beginning months of the pandemic. However, this study show people living with psoriasis should not avoid using their prescribed treatments.