Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: Data from the DA-COVID-19 registry

Background: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic.
Methods: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID-19 pandemic on
the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were
obtained at different timepoints by teledermatology during COVID-19 pandemic,
when regular visits were not allowed due to sanitary restrictions. Disease severity
was assessed by both physician- and patient-reported assessment scores evaluating
itch intensity, sleep disturbances, and AD severity.
Results: A total of 1831 patients were included, with 1580/1831 (86.3%) continuing therapy during pandemic. Most patients were treated with dupilumab (86.1%,
1576/1831) that was interrupted in only 9.9% (156/1576) of cases, while systemic immunosuppressive compounds were more frequently withdrawn. Treatment interruption was due to decision of the patient, general practitioner, or dermatologist in 39.9%
(114/286), 5.6% (16/286), and 30.1% (86/286) of cases, respectively. Fear of increased
susceptibility to SARS-CoV-2 infection (24.8%, 71/286) was one of the main causes of
interruption. Sixteen patients (0.9%) resulted positive to SARS-CoV-2 infection; 3 of
them (0.2%) were hospitalized but no cases of COVID-related death occurred.
Conclusions: Most AD patients continued systemic treatments during COVID pandemic and lockdown period, without high impact on disease control, particularly
dupilumab-treated patients.