Management of patients with atopic dermatitis undergoing systemic
therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19
registry
Abstract
Background: Few and small studies have described the management of
immunomodulant/immunosuppressive therapies or phototherapy in atopic
dermatitis (AD) patients during coronavirus disease 2019 (COVID-19)
pandemic. Methods: A national registry, named DA-COVID-19 and involving
35 Italian dermatology units, was established in order to evaluate the
impact of COVID-19 pandemic on the management of adult AD patients
treated with systemic immunomodulant/immunosuppressive medications or
phototherapy. Demographic and clinical data were obtained at different
timepoints by teledermatology during COVID-19 pandemic, when regular
visits were not allowed due to sanitary restrictions. Disease severity
was assessed by both physician- and patient-reported assessment scores
evaluating itch intensity, sleep disturbances, and AD severity. Results:
A total of 1831 patients were included, with 1580/1831 (86.3%)
continuing therapy during pandemic. Most patients were treated with
dupilumab (86.1%, 1576/1831) that was interrupted in only 9.9%
(156/1576) of cases, while systemic immunosuppressive compounds were
more frequently withdrawn. Treatment interruption was due to decision of
the patient, general practitioner or dermatologist in 39.9% (114/286),
5.6% (16/286), and 30.1% (86/286) of cases, respectively. Fear of
increased susceptibility to SARS-CoV-2 infection (24.8%, 71/286) was
one of the main causes of interruption. Sixteen patients (0.9%)
resulted positive to SARS-CoV-2 infection, 3 of them (0.2%) were
hospitalized but no cases of COVID-related death occurred. Conclusions:
Most AD patients continued systemic treatments during COVID pandemic and
lockdown period, without high impact on disease control, particularly
dupilumab-treated patients.