COVID-19 Hospitalizations with and without Psoriasis (preprint)

ABSTRACT

Background: Psoriasis is an autoimmune chronic skin condition and as suggested by some recent studies, the inflammatory condition might be exacerbated with COVID-19. However, the relationship between psoriasis and COVID-19 infection needs to be investigated further. In our retrospective cohort study, we have attempted to delineate clinical outcomes in COVID-19 hospitalized patients with psoriasis. Methods: Using the 2020 National Inpatient Sample (NIS), we obtained demographic and clinical data and analyzed a total of 1050040 primary COVID-19 adult hospitalizations in the US. We used weighted logistic and linear regression models to determine the association of psoriasis with various clinical outcomes. The models were adjusted for age, sex, race, comorbidities, and hospital characteristics. Using Stata 16.1 (StataCorp, College Station, TX), we accounted for survey design complexity by incorporating sampling weights, primary sampling units, and strata. Results: The psoriasis cohort comprised 5365 (0.511%) patients. For our primary outcome, there was no significant difference between hospital mortality in hospitalized COVID-19 patients with and without psoriasis (11.18% in non-psoriasis patients vs 9.98% in the psoriasis patients, adjusted odds ratio [aOR]; 0.93; 95% CI 0.75 -1.16, p=0.54). Some clinical outcomes were worse for psoriasis patients, and these also had a higher resource utilization. Conclusion: Overall, COVID-19 outcomes do not differ significantly for hospitalized patients with psoriasis than those without. However, psoriatic patients’ trajectory might be affected more owing to higher comorbidities, indicating severe illness.