ABSTRACT
We sought to determine whether biologics and COVID-19 vaccination predicted outcomes in patients with hidradenitis suppurativa (HS) during the COVID-19 global pandemic. We examined self-reported entries from 4/5/2020-12/31/2022. Eligible cases had confirmed diagnoses of HS and COVID-19, and at least 20% survey completion. Outcomes included hospitalization and respiratory support. Threshold dates for COVID-19 vaccine availability, and delta variant and omicron variant strain dominance were 12/14/20, 6/1/21 and 9/26/21, respectively. Fisher exact and Pearson chi2tests were used for comparisons. Multivariable regression adjusted for demographics and comorbidities. Of 428 eligible entries, mean age was 35.2 years (SD 10.2), 90.2% were female and 70% were white. 16.0% reported biologic use at the time of COVID-19 infection. 1 death was reported. Comparing those on biologics vs not, there was higher risk of respiratory support (aOR:1.66, 95%CI [0.60,4.6], P=0.03) but not hospitalization (1.01 [0.26,3.87], P=0.16). After delta variant dominance, there was slightly lower risk of respiratory support (0.95 [0.38,2.38], P=0.04) but not hospitalization (0.62 [0.21,1.86], P=0.14). Risks of hospitalization (0.27 [0.7,1.00], P=0.04) and respiratory support (0.72 [0.28,1.84], P=0.04) were lower after omicron variant. 88% received at least 1 dose of COVID-19 vaccine, 55% of whom received at least 1 booster dose. Risk of respiratory support (aOR:0.52, 95%CI [0.20,1.35], P=0.02), but not hospitalization (0.43 [0.14,1.32], P=0.09), was lower after vaccine availability. A majority reported COVID-19 vaccination and booster. While HS patients on biologics were more likely to require oxygen support in the setting of COVID-19 infection, risk decreased after vaccine availability.Copyright © 2023