Key points are not available for this paper at this time.
Abstract Psoriasis is a chronic, inflammatory, immune-mediated dermatosis associated with multiple comorbidities, such as psoriatic arthritis and uveitis. Systemic inflammation contributes to the pathophysiology of psoriatic complications. Nevertheless, whether patients with psoriasis have a higher risk of developing psoriatic arthritis and uveitis after COVID-19 infection, a disease known to boost inflammatory cytokines, was largely unknown. Therefore, we aimed to investigate the risk of incident psoriatic arthritis and uveitis among patients with psoriasis after COVID-19 infection using real-world data. In this retrospective nationwide study, we analysed data from the US Collaborative Network of the TriNetX Research Database. Adults aged ≥ 18 years diagnosed with psoriasis were eligible for inclusion. Two study cohorts were established: a COVID-19 cohort and a non-COVID-19 cohort. Patients with a diagnosis of COVID-19 between 2020 and 2022 contributed to the COVID-19 cohort. Patients without COVID-19 were matched to construct the non-COVID-19 cohort using 1 : 1 propensity score matching. Multiple covariates, such as age, sex, race, ethnicity, comorbidities, baseline steroid use, systemic immunosuppressant use, and use of biologics, were included to calculate the propensity score. We excluded participants with a history of psoriatic arthritis or uveitis. A Cox regression model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for psoriatic arthritis and uveitis. Stratified analyses according to age, sex, race and ethnicity were also performed. In total 21 186 participants were included. Overall, 1083 patients with COVID-19 and 495 control patients developed psoriatic arthritis during the follow-up. Patients with psoriasis after COVID-19 infection had an increased risk of incident psoriatic arthritis (HR 2.16, 95% CI 2.07–2.25) compared with those without COVID-19. Moreover, 748 patients with COVID-19 and 401 control patients developed uveitis. Patients with psoriasis with COVID-19 had an increased risk of incident uveitis (HR 1.83, 95% CI 1.70–1.97) compared with those without COVID-19. The increased risk of psoriatic arthritis and uveitis remained significant among men, White patients, and those aged 45 years. In conclusion, patients with psoriasis after COVID-19 infection have an associated increased risk of psoriatic arthritis and uveitis. Long-term follow-up of complications such as psoriatic arthritis and uveitis may be considered for patients with psoriasis after COVID-19 infection. Future research is warranted to elucidate the pathophysiology linking psoriasis, COVID-19 and psoriatic comorbidities.
Chen et al. (Fri,) studied this question.