A multicenter prospective study assessed the effects of COVID-19 infection and vaccination of patients with atopic dermatitis, psoriasis, and vitiligo.
Published in The Journal of Dermatology, the cohort study included 424 participants aged 18 and older, enrolled in the Target2B! sub study between February 2021 and October 2022. Data collection involved standardized electronic case report forms, with seroconversion measured 28 days post-vaccination. Multivariable logistic regression analyzed confounding factors, including age, sex, BMI, and comorbidities.
COVID-19 incidence was highest among patients with vitiligo (51.1%), followed by those with atopic dermatitis (AD) (42%) and psoriasis (34.3%). Hospitalization rates due to COVID-19 were minimal, with only three cases recorded and no significant mortality.
Vaccination elicited effective seroconversion in nearly all patients, with rates of 100% in vitiligo patients, 97.9% in those with psoriasis, and 96.5% among patients with AD.
Increased dermatological immune-mediated inflammatory diseases (DIMID) activity was reported by 6.6% of patients following COVID-19 infection and by 12.3% after vaccination. Baseline progressive disease emerged as the only significant risk factor for heightened disease activity, with odds ratios (OR) of 4.27 post-COVID-19 and 3.45 post-vaccination.
"Older age was associated with significantly lower seroconversion rates after the first or second vaccination (p < 0.001), whereas older age was not affected by progressive disease at baseline (p = 0.64), baseline immunization (p = 0.35), or sex (p = 0.80)," noted Nicoline F. van Buchem-Post from the Department of Dermatology, Netherlands Institute for Pigment Disorders, Amsterdam University, and colleagues.
DIMID patients can safely continue immunosuppressive therapy, as it does not increase the risk of contracting COVID-19, according to study investigators. Vaccination responses were robust across all patient groups, supporting immunization strategies. However, close monitoring of patients with progressive disease is critical due to their higher risk of experiencing disease activity flare-ups.
"No alarming signs were shown in this study regarding (severe) COVID-19 in patients with AD, psoriasis, or vitiligo," van Buchem-Post. Further research is warranted to explore why vitiligo patients exhibited higher COVID-19 susceptibility, noted study investigators.
Full author disclosures are available in the published article.
