Impact of COVID-19 on Medical Care Conduct and Psychological Burden Among Patients With Psoriasis: Real-World Data From a Tertiary Hospital in China

Objective: The ongoing coronavirus disease 2019 (COVID-19) epidemic has caused extensive damage worldwide. We explored whether the medical care conduct of patients with psoriasis has changed and whether the COVID-19 epidemic has placed more psychological pressure on these patients. Methods: A questionnaire survey was administered to patients with psoriasis in the Dermatology Department of Peking University Third Hospital in July 2022. Information about the patients’ general demographics, psoriasis condition, mental state of anxiety (Generalized Anxiety Disorder-7 [GAD-7] score), changes in medical care conduct, and Concerns about COVID-19-Related Risk Score for Psoriasis (CCRSP, a self-designed questionnaire) was collected. Univariate analysis with the Mann–Whitney U test for continuous variables was used in the estimation of statistical differences. Results: A total of 112 patients with psoriasis completed the survey. Purchasing medicine was the factor that added difficulty for most participants (32.1%). Fewer participants (26.8%) encountered medical registration difficulties than economic and transportation difficulties. Nearly three-quarters of participants (73.2%) reported at least one medical care conduct change resulting from the COVID-19 epidemic. A small proportion of participants (12.5%) thought that COVID-19 prevented them from seeking medical services for psoriasis. The top three items that caused the most concern were psoriasis aggravation resulting from drug reduction and withdrawal because of COVID-19 (44.7%), psoriasis aggravation after infection with COVID-19 (38.4%), and psoriasis-related side effects of the COVID-19 vaccine (35.7%). The GAD-7 score of patients with a high CCRSP (score of >10) was significantly higher than that of patients with a low CCRSP (score of ≤10) (nonparametric test, P = 0.047). Conclusion: COVID-19 poses challenges and places a mental burden on patients with psoriasis. Doctors should regulate the medical behavior of patients with psoriasis according to their specific COVID-19 situation and help patients ease their anxiety to maintain the stability of their psoriasis condition.

[1]  L. Chularojanamontri,et al.  Do different platforms of coronavirus vaccines have different impacts on psoriasis flares? , 2023, Experimental dermatology.

[2]  D. Schadendorf,et al.  COVID-19 vaccination in psoriasis patients receiving systemic treatment: A prospective single-center study , 2023, Frontiers in Immunology.

[3]  J. Yazdany,et al.  Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis: data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries , 2023, Annals of the Rheumatic Diseases.

[4]  M. Del Fabbro,et al.  Heterologous versus homologous primary and booster COVID‐19 vaccination do not increase flare rate in patients with psoriasis and/or psoriatic arthritis: Insights from a real‐life, multicenter, case–control study , 2023, Journal of the European Academy of Dermatology and Venereology : JEADV.

[5]  G. Fabbrocini,et al.  The Role of Teledermatology During the COVID-19 Pandemic: A Narrative Review , 2022, Clinical, cosmetic and investigational dermatology.

[6]  E. Ustaoğlu The Effect of the COVID-19 Pandemic on Stress-related Dermatologic Diseases. , 2022, Acta dermatovenerologica Croatica : ADC.

[7]  F. Kılıç,et al.  COVID-19 Knowledge in Patients with Psoriasis Receiving Systemic Therapy: a Questionnaire Study , 2022, Dermatology practical & conceptual.

[8]  I. Tzoulaki,et al.  Psoriasis and COVID-19: A bidirectional Mendelian randomization study , 2022, Journal of the American Academy of Dermatology.

[9]  Chun-Bing Chen,et al.  New Onset and Exacerbations of Psoriasis Following COVID-19 Vaccines: A Systematic Review , 2022, American Journal of Clinical Dermatology.

[10]  A. Egeberg,et al.  The risk of COVID-19 in patients with psoriasis: A retrospective cohort study , 2022, Journal of the American Academy of Dermatology.

[11]  Ping Wang,et al.  Will People Accept a Third Booster Dose of the COVID-19 Vaccine? A Cross-Sectional Study in China , 2022, Frontiers in public health.

[12]  National Health Commission Of The People's Republi National guidelines for diagnosis and treatment of cervical cancer 2022 in China (English version). , 2022, Chinese journal of cancer research = Chung-kuo yen cheng yen chiu.

[13]  M. Gianfrancesco,et al.  OP0249 CHARACTERISTICS ASSOCIATED WITH POOR COVID-19 OUTCOMES IN PEOPLE WITH PSORIASIS AND SPONDYLOARTHRITIS: DATA FROM THE COVID-19 PsoProtect AND GLOBAL RHEUMATOLOGY ALLIANCE PHYSICIAN-REPORTED REGISTRIES , 2022, Annals of the Rheumatic Diseases.

[14]  L. Ferris,et al.  COVID-19 vaccine safety and efficacy in patients with immune-mediated inflammatory disease: Review of available evidence , 2021, Journal of the American Academy of Dermatology.

[15]  L. Naldi,et al.  Preference for Telemedicine Versus In-Person Visit Among Patients with Psoriasis Receiving Biological Drugs , 2021, Dermatology and Therapy.

[16]  Mona El-Kalioby,et al.  How does COVID‐19 impact psoriasis practice, prescription patterns, and healthcare delivery for psoriasis patients? A cross‐sectional survey study , 2021, Journal of cosmetic dermatology.

[17]  W. Peitsch,et al.  Psoriasis care during the time of COVID-19: real-world data on changes in treatments and appointments from a German university hospital , 2021, European Journal of Dermatology.

[18]  M. Lebwohl,et al.  National Psoriasis Foundation COVID-19 Task Force guidance for management of psoriatic disease during the pandemic: Version 2—Advances in psoriatic disease management, COVID-19 vaccines, and COVID-19 treatments , 2021, Journal of the American Academy of Dermatology.

[19]  S. Feldman,et al.  Factors associated with adverse COVID-19 outcomes in patients with psoriasis—insights from a global registry–based study , 2020, Journal of Allergy and Clinical Immunology.

[20]  O. Distler,et al.  Impact of the COVID-19 pandemic on the disease course of patients with inflammatory rheumatic diseases: results from the Swiss Clinical Quality Management cohort , 2020, Annals of the Rheumatic Diseases.

[21]  K. Bhaskaran,et al.  OpenSAFELY: factors associated with COVID-19 death in 17 million patients , 2020, Nature.

[22]  J. Gelfand,et al.  The risk of respiratory tract infections and symptoms in psoriasis patients treated with interleukin 17 pathway–inhibiting biologics: A meta-estimate of pivotal trials relevant to decision making during the COVID-19 pandemic , 2020, Journal of the American Academy of Dermatology.

[23]  J. Martínez-Ortega,et al.  Quality of life, anxiety and depressive symptoms in patients with psoriasis: A case-control study. , 2019, Journal of psychosomatic research.

[24]  A. Bulbena,et al.  Patients with Moderate to Severe Psoriasis Associate with Higher Risk of Depression and Anxiety Symptoms: Results of a Multivariate Study of 300 Spanish Individuals with Psoriasis. , 2019, Acta dermato-venereologica.

[25]  W. Gulliver,et al.  The prevalence of anxiety in patients with psoriasis: a systematic review of observational studies and clinical trials , 2017, Journal of the European Academy of Dermatology and Venereology : JEADV.

[26]  Jianzhong Zhang,et al.  Epidemiology and treatment of psoriasis: a Chinese perspective , 2014 .

[27]  National Health Commission of the PRC National guidelines for diagnosis and treatment of cervical cancer 2022 in China (English version) , 2022, Chinese Journal of Cancer Research.