key: cord-0727099-ra0vulpi
authors: Barrutia, Leire; Volo, Victor; Ruíz‐Sánchez, Daniel; Valtueña, Jara; Aguado García, Angel; Manchado López, Pilar
title: COVID‐19 and biologic therapies in dermatology: seroprevalence survey and severity analysis in a tertiary hospital in Spain
date: 2021-02-09
journal: Int J Dermatol
DOI: 10.1111/ijd.15467
sha: c596a514cfc848a28d3d187da39ff6508ffde927
doc_id: 727099
cord_uid: ra0vulpi

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lyzing the added risk that these patients might have, it must be taken into account that a big percentage of SARS-CoV-2 infections have an asymptomatic course. 3 Therefore, it is essential to perform systematic studies that actively search for asymptomatic cases.

For this reason, we conducted a systematic seroprevalence study taking into account all the patients undergoing biologic treatment in our department. All the patients had been treated with biologic therapies for more than 1 year, except for two, which had been undergoing treatment for over 6 months.

This included patients with psoriasis, hidradenitis, urticaria, and atopic dermatitis undergoing treatment with infliximab, adalimumab, etanercept, ustekinumab, secukinumab, ixekizumab, omalizumab, and dupilumab. The data collection process was as follows. First, we listed all the patients mentioned above (138 patients). We then excluded patients that did not want to participate in the study and those who had stopped treatment during the pandemic, finally obtaining 99 patients (n = 99). Second, we conducted telephone interviews with all the patients.

We asked them about comorbidities and about whether they had any COVID-19-related symptoms or a confirmed diagnosis of the infection by reverse-transcription polymerase chain reaction (RT-PCR). Finally, we performed an enzyme-linked immunosorbent assay (ELISA) serological test for SARS-CoV-2 on every patient. The statistical analysis of these data was performed using Stata (version 14).

Our sample traits included the following ( Table 1 ). The mean age was 54 years (AE13.6), and 62% were men. The most common dermatologic disease was psoriasis (83%). Almost half of the patients were undergoing treatment with ustekinumab (42%). The most prevalent comorbidities were tobacco use (38%), dyslipidemia (36%), hypertension (27%), and obesity (27%); diabetes (17%) and respiratory diseases (16%) were less common.

Out of the 99 patients, four had high IgG titers (a positive result) for SARS-CoV-2, which corresponded to 4.1% (95% CI 1.4-9.3) of the sample ( Table 2) . One of the patients was admitted to the hospital, but the reason for hospital admission was progression of Alzheimer's disease. He tested positive for SARS-CoV-2 by RT-PCR, but he did not show symptoms related to COVID-19 nor compatible blood tests or radiology exam. Therefore, COVID-19 was considered an incidental finding. Another patient had COVID-19-related symptoms but did not require hospital admission. The remaining two patients were asymptomatic.

Seroprevalence in our sample was 4.04%, which was very similar to the general population of Valladolid (4.4%). 3 Performing a serological test on every patient allows for a realistic comparison between patients treated with biologic therapies and the The reason for hospital admission was not COVID-19 but progression of Alzheimer´s disease.

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