Impact of the COVID-19 pandemic waves on adults with moderate-to-severe atopic dermatitis in the Dutch general population: a population-based longitudinal cohort study

Background This study aimed to investigate the impact of COVID-19 waves on mental health, pandemic-related wellbeing, and social functioning in adults with moderate-to-severe atopic dermatitis (AD) and without AD in the Dutch general population. Methods Between 2020 and 2022, 31 COVID-19 questionnaires (COVQs) were sent to 140,145 Lifelines adult participants, collecting data on mental health [major depression disorder (MDD), generalized anxiety disorder (GAD)], pandemic-related wellbeing [COVID-19-related concerns, quality of life (QoL)], and social functioning (loneliness, social relations). AD information was collected through a digital questionnaire sent to all Lifelines adults in 2020. Data were divided into three waves according to the COVID-19 timeline in the Netherlands: March–June 2020 (wave 1); July 2020–June 2021 (wave 2); July 2021–October 2022 (wave 3). Generalized linear mixed models were performed for each outcome. Results In total, 49,216 participants with 790,936 completed COVQs were included. Compared with wave 1, almost all health-related outcomes, including the prevalence of MDD and GAD, COVID-19-related concerns, loneliness, and QoL, had returned to similar levels by wave 3 in the overall population, while social relations remained impaired. Furthermore, participants with moderate-to-severe AD, women, young adults (18–29 years), and those with a history of mental health problems showed worse health-related outcomes than their counterparts. Conclusion Both participants with and without moderate-to-severe AD showed partial recovery in mental health and wellbeing by the third COVID-19 wave; however, social relations remained impaired. Individual with moderate-to-severe AD, women, younger adults, and those with pre-existing mental health problems were more affected overall. Future studies should focus on developing strategies to improve social connectedness, and vulnerable groups warrant continued attention.