Biologics increase the risk of SARS-CoV-2 infection and hospitalization, but not ICU admission and death: Real-life data from a large cohort during red-zone declaration

Dermatol Ther. 2020 Sep;33(5):e13475. doi: 10.1111/dth.13475. Epub 2020 May 19.


During COVID-19 outbreak there are discordant opinions toward the impact of biologics in psoriatic (PsO) patients. Thus we performed a single-center case-control study in Lombardia, the Italian region with the higher number of COVID-19 confirmed cases. We enrolled 1193 PsO patients treated with biologics and small molecules and we used the entire Lombardia population as controls. Notably, 17 PsO patients COVID-19 confirmed were quarantined at home and five hospitalized, no PsO patients were admitted to intensive care unit (ICU) or died. With respect to the general population of Lombardy, patients on biologics were at higher risk to test positive for COVID-19 (odds ratio [OR] 3.43 [95% confidence interval (CI) 2.25-5.73], P < .0001), to be self-quarantined at home (OR 9.05 [95% CI 5.61-14.61], P < .0001) and hospitalized (OR 3.59 [95% CI 1.49-8.63], P = .0044), however, not increased risk of ICU admission or death were found. PsO patients on biologics should be carefully monitored with telemedicine during COVID-19 outbreak and early treated at home to limit hospital overwhelm.

Keywords: COVID-19; SARS-CoV-2; bilateral interstitial pneumonia; biologics; pandemic; psoriasis; psoriatic arthritis.

MeSH terms

  • Adult
  • Aged
  • Biological Products / adverse effects*
  • COVID-19 / etiology*
  • COVID-19 / mortality
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Hospitalization
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Psoriasis / drug therapy*
  • Risk
  • SARS-CoV-2*


  • Biological Products