Influence of biologics on COVID-19-positive patients: a case series

ABSTRACT

The association between COVID-19 and biologics - drugs that modulate the immune system through stimulatory or inhibitory actions - is currently not well understood. COVID-19 is associated with the presence of a cytokine storm. This suggests the inflammatory response may influence disease progression and pathogenesis (Tang Y, Liu J, Zhang D et al. Cytokine storm in COVID-19 the current evidence and treatment strategies. Front Immunol 2020;11 1708). To the authors' knowledge there is minimal research outlining the effect of biologics on patients with skin disease who are infected with COVID-19. The aim of this case series was to evaluate the effect of COVID-19 infection on patients taking biologics for dermatological conditions. Clinical characteristics of 14 patients under Dermatology care on biologics and COVID-19 positive confirmed by polymerase chain reaction were reviewed retrospectively. A 20-item tool was used to collect quantitative data. This encompassed demographics, skin disease, biologics, hospitalization, intensive care admission, severity of disease as determined by oxygen therapy, imaging and symptoms, and presence of long COVID. The majority of patients included had multiple comorbidities (71%), 21% of which had a respiratory condition. Approximately one-third of cases required hospitalization (36%) and oxygen (29%). However, none required intensive care admission or noninvasive ventilation, and chest X-ray findings from all participants were clear, illustrating no scarring or evidence of long-COVID clinical changes. Patients on biologics infected with COVID-19 in this series appear to have been mildly affected by COVID despite being a comorbid group. The outcomes of patients following infection with COVID-19 on a biologic were good and this did not seem to affect the clinical outcomes or mortality in this cohort. Biologics appeared to demonstrate a protective benefit.