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


Collaborators: Caldarola G, Silvaggio D, Dattola A, Napolitano M, Ferrucci SM, Dal Bello G, Bianchelli T, Rovati C, Pigliacelli F, Ortoncelli M, Hansel K, Calabrese G, Loi C, Iannone M, Veronese F, Romita P, Tronconi G, Caroppo F, Tilotta G, Sernicola A, Esposito M, Raponi F, Gualdi G, Rech G, Musumeci ML, Nisticò SP, Campitiello A, Bonzano L, Piras V.
Author information:
(1)Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
(2)Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy.
(3)Dermatology Unit, Policlinico Tor Vergata, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.
(4)Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
(5)Dermatology Unit, Fondazione IRCCS Ca, Granda Ospedale Maggiore Policlinico, Milan, Italy.
(6)Department of Pathophysiology and Transplantation, UniversitàdegliStudi di Milano, Milan, Italy.
(7)Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
(8)Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy.
(9)Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
(10)Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy.
(11)Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy.
(12)Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy.
(13)Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
(14)Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
(15)Dermatology UOC, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.
(16)Department of Biomedical, Surgical and Dental Sciences, Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy.
(17)Department of Dermatology, University of Pisa, Pisa, Italy.
(18)Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
(19)Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.
(20)Department of Biomedical Science and Human Oncology, Unit of Dermatology, University of Bari, Bari, Italy.
(21)Dermatology Clinic, Department of Health Sciences, University of Florence, Florence, Italy.
(22)Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy.
(23)Section of Dermatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
(24)Unit of Dermatology, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.
(25)Department of Medicine and Surgery, Section of Dermatology, University of Parma, Parma, Italy.
(26)Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
(27)Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.
(28)Dermatology Unit, Department of MedicalSpecialties, Arcispedale Santa Maria Nuova-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
(29)Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy.
(30)Department of Medicine and Aging Science, Dermatologic Clinic, G. D'Annunzio University, Chieti, Italy.
(31)Division of Dermatology, Santa Chiara Hospital, Trento, Italy.
(32)Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit, Daniele Innocenzi, Sapienza, University of Rome - Polo Pontino, Rome, Italy.
(33)Dermatology Clinic, University of Catania, Catania, Italy.
(34)Dermatology Unit, Department of Health Sciences, Università Magna Graecia, Catanzaro, Italy.
(35)Department of Dermatology, University of Trieste, Trieste, Italy.
(36)Unit of DermatologicalDiseases, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy.
(37)Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.


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.