Atopic dermatitis is not associated with SARS-CoV-2 outcomes

Abstract

Atopic dermatitis is characterized by immune dysregulation, which may predispose toward worse COVID-19 outcomes. We conducted a retrospective cohort study to investigate the relationship of atopic dermatitis with COVID-19 symptom severity, hospitalization, length of hospital stay, requirement for oxygen therapy, long-term morbidity and mortality. Multivariable logistic regression models were constructed to examine the impact of atopic dermatitis (independent variable) on COVID-19 symptom severity, hospitalization, length of hospital stay, requirement for oxygen therapy, long-term morbidity and mortality (dependent variables). SARS-CoV-2 positive adult patients with diagnosed AD had similar odds of hospitalization (adjusted odds ratio [95% confidence interval]: 0.51 [0.20-1.35]), acute level of care at initial medical care (0.67 [0.35-1.30]), severecritical SARS-CoV-2 (0.82 [0.29-2.30]), requirement of supplemental non-mechanical oxygen therapy (1.33 [0.50-3.58]), extended hospital stay (2.24 [0.36-13.85]), lingering COVID-19 symptoms (0.58 [0.06-5.31]) and COVID-19 death (0.002 [< 0.001-> 999]) compared to patients without AD. Our findings suggest AD is not an independent risk factor for COVID-19 severity or complications.

COVID-19 Outcomes in Pediatric Patients With Atopic Dermatitis: A Multicenter Analysis

“…Previous studies showed no association of COVID-19related complications for adult AD. 3 This study's results suggest similar findings in pediatric AD patients because they demonstrated no higher risk of COVID-19-related complications. However, pediatric AD patients demonstrated a lower risk for 30-day hospitalization compared with matched non-AD children.…”

“…Research on COVID-19 outcomes in pediatric AD patients is sparse. Previous studies showed no association of COVID-19–related complications for adult AD 3 . This study's results suggest similar findings in pediatric AD patients because they demonstrated no higher risk of COVID-19–related complications.…”

Association between atopic dermatitis and COVID-19 infection: A case-control study in the All of Us research program

“…However, AD has not been associated with increased COVID-19 severity or complications in other epidemiologic studies. 18 Asthma, which shares a similar immunologic profile to AD with IL-4 and IL-13-mediated airway inflammation, has also not been correlated with an increased risk of COVID-19 infection or severe disease. [19][20][21] Several hypotheses have been proposed to explain these findings, including the variable role of type 2 immune response in responding to SARS-CoV-2, as well as other physiological changes in asthma, asthma medications, and behavioral factors.…”

Allergic disease as a causal protective factor for severe covid-19: a multivariable mendelian randomization study

“…AD, a form of eczema, is an allergic skin disease often related to asthma, food allergy, allergic conjunctivitis, and AR 29 . In observational studies, the relationship between AD and COVID-19 remained murkier: some studies [30][31][32] suggested that AD was associated with increased risk for COVID-19, while others suggested that it was associated with reduced risk [33][34][35] or had no effect 36 . Cohort studies have shown a reduced risk of SARS-CoV-2 infection in patients with AD treated with Dupilumab 35 .…”