key: cord-0855503-u6ml5szo
authors: Ahmed, S.M.A.; Volontè, M.; Isoletta, E.; Vassallo, C.; Tomasini, C.F.; Lilleri, D.; Zelini, P.; Musella, V.; Klersy, C.; Brazzelli, V.
title: SARS‐CoV‐2 serology in patients on biological therapy or apremilast for psoriasis: a study of 93 patients in the Italian red zone
date: 2021-10-14
journal: J Eur Acad Dermatol Venereol
DOI: 10.1111/jdv.17721
sha: a52fe9c96d88ed3825ee985b0a0ae1eec591e364
doc_id: 855503
cord_uid: u6ml5szo

Lombardy, Italy was one of the most heavily impacted areas in the world during the height of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, quickly becoming the epicenter within Italy. There have been 845,898 cases reported to date July 19, 2021 within Lombardy, accounting for approximately 20% of the cases overall in Italy.1 During the height of the pandemic, concern was raised over the use of biologics for psoriasis as they necessitate some degree of immunomodulation.2.

levels, corresponding to an incidence rate of 13%. None of the 12 positive patients had a severe infection or required hospitalisation due to SARS-CoV-2 infection.

In terms of patient-specific variables, sex, age, place of work, number of family members, and type of systemic therapy did not seem to significantly alter the likelihood of having a positive SARS-CoV-2 serology. The most commonly used type of systemic therapy was Anti-TNF-a (43% of patients) which also accounted for 9/12 (75%) positive patients.

Between the comorbidities analysed (Table 2) , only a history of cardiovascular disease was associated with a statistically significant increase in SARS-CoV-2 seroprevalence [Odds Ratio (OR) 5.07 P-value = 0.045 (95% CI 1.03-24.8)].

Statistical analysis between serological data and over-the-phone questionnaires performed by Brazzelli et al. 3 showed a strong association [OR 9.60 P-Value = 0.001 (95% CI 2.43-37.9)] between questionnaire positivity and serological positivity.

In conclusion, we found an incidence rate of 13%, within the range from the literature for Italy (7.7% 4 -19.7% 5 ). The use of biological drugs and apremilast for psoriasis does not seem to increase severity of the disease or susceptibility to SARS-CoV-2 infections, similar to findings from the literature. 6, 7 Data from our sample cohort suggests that patients with cardiovascular disease may be at an increased risk of contracting SARS-CoV-2.

Finally, over-the-phone questionnaires for SARS-CoV-2 positivity are a potentially useful diagnostic tool during the heights of pandemics where in-person meetings may not be possible. 

Covid-19 -Situazione in Italia

Should biologics for psoriasis be interrupted in the era of COVID-19?

Does therapy with biological drugs influence COVID-19 infection? Observational monocentric prevalence study on the clinical and epidemiological data of psoriatic patients treated with biological drugs or with topical drugs alone

SARS-CoV-2 seroprevalence worldwide: a systematic review and meta-analysis

Seroprevalence of SARS-CoV-2 in blood donors from the Lodi Red Zone and adjacent Lodi metropolitan and suburban area

Biologics for psoriasis patients in the COVID-19 era: more evidence, less fears

Anti-TNF-a agents in inflammatory bowel disease and course of COVID-19

The patients in this manuscript have given written informed consent to publication of their case details. We thank the nurses Anna M. and Anna P. whose help made this study possible and our patients for their passionate collaboration.

The authors have no conflicts of interest to declare.

None.

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.