National Psoriasis Foundation COVID-19 Task Force Guidance for Management of Psoriatic Disease During the Pandemic: Version 1

Abstract

Objective To provide guidance about management of psoriatic disease during the COVID-19 pandemic. Study Design A task force (TF) of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was convened. The TF was supplemented by non-voting members which included fellows and National Psoriasis Foundation (NPF) staff. Clinical questions relevant to the psoriatic disease community were informed by questions received by the NPF. A Delphi process was conducted. Results The TF approved 22 guidance statements. The average of the votes was within the category of agreement for all statements. All guidance statements proposed were recommended, 9 with high consensus, 13 with moderate consensus. Limitations The evidence behind many guidance statements is limited in quality. Conclusion These statements provide guidance for the management of patients with psoriatic disease on topics ranging from how the disease and its treatments impact COVID-19 risk and outcome, how medical care can be optimized during the pandemic, what patients should do to lower their risk of getting infected with SARS-CoV-2 and what they should do if they develop COVID-19. The guidance is intended to be a living document that will be updated by the TF as data emerge.

Psoriasis Management During the COVID-19 Pandemic

“…They should always wear face coverings/masks in public places, maintain physical distancing, and wash hands regularly with soap and water and use hand sanitizers frequently. [ 3 7 ] If a psoriasis patient has had close contact with COVID-19 infected person and/or experiences signs or symptoms of COVID-19 infection, then the patient is advised to stay home (14 days of home quarantine for contacts at present, subject to direction of the public health authorities) without going out and should seek medical attention without fail. [ 7 ]…”

“…It is not clear whether patients with psoriasis and/or psoriatic arthritis are at increased risk of contracting SARS-CoV-2 or having a worse course of COVID-19 illness. [ 7 ]…”

“…It is to be noted that several of these risk factors are components of metabolic syndrome, a known association of psoriasis. [ 3 7 ]…”

“…In general, patients need not stop their biologic or oral therapies for psoriasis if they do not have any serious comorbidities and if their hematological and biochemical test results like complete blood picture, liver function tests, lipid profile, kidney function tests, etc., and also chest X-ray are normal. [ 3 7 ] For most patients, the benefit of continuing treatments for psoriasis outweighs the hypothetical risks of poor COVID-19-related outcomes.…”

“…It is recommended that Individuals in high-risk groups should consult/have a conversation with their treating doctors and clear their doubts about whether it is recommended to continue the therapy or alter the therapy. [ 3 7 ]…”