Atopic dermatitis: epidemiology, lifestyle factors and COVID-19-related impact in the Dutch general population

ABSTRACT

Background: Atopic dermatitis (AD) causes a considerable public health burden, especially among patients with moderate-to-severe disease. A large epidemiological study has not been conducted in the Netherlands. Objectives: To investigate the prevalence and severity of AD in the Dutch general population and its associations with lifestyle factors and COVID-19-related impact. Methods: A cross-sectional study was conducted within the Lifelines Cohort Study by sending an AD questionnaire in 2020 and multiple COVID-19 questionnaires between 2020 and 2021, to 139 735 adults. Lifestyle factors were collected at baseline between 2006 and 2013. Associations between AD, lifestyle factors, and COVID-19-related impact, were analysed using binary logistic regression and/or linear regression models. Results: 57643 subjects (42.5%) responded to the AD questionnaire, of those 53 545 responded to at least one COVID-19 questionnaire. The lifetime prevalence was 9.3%, and the point prevalence of moderate-to-severe AD was 2.3%. Moderate-to-severe AD was associated with smoking pack-years, >2 alcoholic drinks per day, chronic stress, and obesity. Moreover, the COVID-19 pandemic had a greater psychological impact on the subjects with moderate-to-severe AD, who were also more concerned about COVID-19 vaccines and healthcare system and tended to take more precautions for prevention. Conclusions: Moderate-to-severe AD represents a large proportion of AD patients and shows positive associations with lifestyle factors and a profound COVID-19-related impact. More attention to lifestyle factors and patient's overall welling appears warranted in those severely affected. Further longitudinal studies are required to better characterize the direction of these associations and develop strategies for coping.