IMPORTANCE The overall comorbidity burden among patients with hidradenitis suppurativa (HS) has not been systematically evaluated. OBJECTIVES To investigate the standardized overall comorbidity burden among patients with HS and to compare it with the comorbidity burden in patients with psoriasis and a control group. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional analysis was conducted of 5306 patients with HS, 14 037 patients with psoriasis, and 1 733 810 controls identified using electronic health records data from October 1, 2013, through October 1, 2018. MAIN OUTCOME AND MEASURE The primary outcome was the mean Charlson Comorbidity Index (CCI) score. RESULTS Each matched cohort had 3818 patients (2789 women and 1029 men; mean [SD] age, 45.7 [15.0]). Before matching, the overall mean (SD) CCI score was highest among the psoriasis cohort (2.33 [3.13]), followed by the HS cohort (1.80 [2.79]) and control cohort (1.26 [2.35]). In matched analyses, the overall mean (SD) CCI score was highest among the HS cohort (1.95 [2.96]), followed by the psoriasis cohort (1.47 [2.43]; P < .001) and control cohort (0.95 [1.99]; P < .001) patients. A total of 516 patients with HS (13.5%) had an overall mean CCI score of 5 or greater. Mean CCI score was highest for patients with HS across all sex, race, and age groups. The most common comorbidities among patients with HS were chronic pulmonary disease (1540 [40.3%]), diabetes with chronic complications (365 [9.6%]), diabetes without chronic complications (927 [24.3%]), and mild liver disease (455 [11.9%]). Patients with HS with a CCI score of 5 or greater had 4.97 (95% CI, 1.49-16.63) times the adjusted risk of 5-year mortality compared with patients with HS with a CCI score of zero. CONCLUSIONS AND RELEVANCE Patients with HS have a higher overall comorbidity burden compared with patients with psoriasis and a control group. A significant proportion of patients with HS have CCI scores of 5 or greater, which are associated with increased mortality. This degree of comorbidity burden may warrant multidisciplinary implementation of routine screening measures.

Risk of long-term opioid use among patients with hidradenitis suppurativa (HS), who experience pain that substantially impairs quality of life, is unknown to date. OBJECTIVE To compare overall and subgroup incidence of long-term opioid use in a population of opioid-naive patients with HS and control patients. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study was based on a demographically heterogeneous population-based sample of more than 56 million unique patients from

idradenitis suppurativa (HS) is a chronic inflammator y skin disease of the pilosebaceous unit that affects axillary, inguinal, perineal, and inframammary regions. 1 Hidradenitis suppurativa has been linked to risk mediators of cardiovascular disease, including obesity, 2 , 3 smoking, 4 diabetes, 5 and the metabolic syndrome. 6,7 However, risk of cardiovascular events among patients with HS is not well established. The purpose of this investigation was to compare the incidence of myocardial infarction (MI) and cerebrovascular accident (CVA), the composite of which we have defined as major adverse cardiac event (MACE), in a population of patients with HS and control individuals in the United States. We also aimed to identify subgroups who may be at higher risk for MI and CVA and evaluate potential risk differences among patients treated with biologic agents. Methods Patient Population This was a retrospective cohort analysis using a multihealth system data analytics and research platform (Explorys). 8 Clinical information from electronic medical records, laboratories, practice management systems, and claims systems is matched using the single set of Unified Medical Language System ontologies to create longitudinal records for unique patients. Data are standardized and curated according to com-IMPORTANCE Although hidradenitis suppurativa (HS) is associated with several cardiovascular risk mediators, information on the risk of myocardial infarction (MI) and cerebrovascular accident (CVA) in this population is sparse. OBJECTIVE To compare risk of MI, CVA, and composite disease (MI or CVA) in patients with HS, stratified by use of biologic agents, with controls without HS.

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Background and aims COVID-19 pandemic has strained the health infrastructure globally, providing an opportunity to identify cost-effective biomarkers. We aimed to identify simple hematological prognostic markers in hospitalized severe COVID-19 patients with and without diabetes. Methods Retrospective study of RT-PCR confirmed hospitalized severe COVID-19 patients (total: n = 154 patients, including diabetic subset n = 57) were analyzed. Clinically applicable cut-offs were derived using receiver operating characteristic (ROC) curve analysis for total leucocyte count (TLC), absolute neutrophil count (ANC), neutrophil lymphocyte ratio (NLR), and derived neutrophil lymphocyte ratio (dNLR) in order to prognosticate the outcome. Results Among 154 severe COVID-19 patients, significant association with mortality was seen with respect to TLC(p < 0.001), ANC (p < 0.001), NLR(p < 0.001) and dNLR(p < 0.001). In the total cohort, applicable cut-offs based on ROC curve in predicting outcome were, for TLC 8950 cells/mm 3 (area under curve (AUC)-0.764, odds ratio (OR)-7.53), ANC 7679 cells/mm 3 (AUC-0.789, OR-8.14), NLR 5.13 (AUC-0.741, OR-4.77), dNLR 3.44 (AUC -0.741, OR-4.43) respectively.In diabetic subset, the cut-offs for TLC was 8950 cells/mm 3 (AUC -0.762, OR-14.9), ANC 6510 cells/mm 3 (AUC -0.773, OR-16.8), NLR 5.13(AUC -0.678, OR-6) and dNLR 3.25(AUC -0.685, OR-4.7) respectively. Conclusions In severe COVID-19 patients irrespective of diabetes, a simple, applicable total leucocyte count cut-off, 8950 cells/mm 3 , together with easily derived cut-offs for ANC, NLR, dNLR may serve as cost-effective prognosticators of clinical outcome. A normal TLC may be misleading in the intensive care and the above applicable cut-off for TLC serves as an early warning tool for high-risk identification and better in-hospital management. Even with similar or lower cut-offs, diabetics had a higher mortality.