COVID-19 and Psoriasis: A Concise Systematic Review

Abstract

Introduction: The effects on human health caused by the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) lead to hyperinflammation processes, which can lead to meta-inflammation. This process can aggravate skin diseases, especially psoriasis. This is a chronic inflammatory skin disease associated with significant morbidity. This problem affects about 2-3% of people worldwide. Objective: to demonstrate, through a concise systematic review, the main considerations about the relationship between COVID-19 and psoriasis, showing the possible mechanisms for the worsening of this dermatological disease. Methods: The research was carried out from June 2021 to July 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: Psoriasis is a common chronic inflammatory skin disease and is autoimmune. Patients with COVID-19 may have features of hyper inflammation and even meta-inflammation. The triggering or exacerbating factor of psoriasis may be medications and, in addition, patients with COVID-19 may have psoriasis exacerbation. Reports indicated that psoriasis patients using biological products were no longer susceptible to COVID-19 and the severe clinical course of the disease. It is envisioned that the use of azithromycin in cases of COVID 19 with pre-existing psoriasis can alleviate psoriatic lesions. Conclusion: The COVID 19 pandemic had a direct impact on dermatological diseases, especially psoriasis. Difficulty in accessing health care services and the stress load caused exacerbations in psoriasis cases. Studies recommend avoiding classic immunosuppressive agents such as methotrexate, cyclosporine, and TNF alpha inhibitors. Reports indicated that psoriasis patients using biological products were no longer susceptible to COVID-19 and the severe clinical course of the disease.