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TOPLINE: 

Among patients with dermatological immune-mediated inflammatory diseases (DIMIDs), those with vitiligo had a higher risk of developing COVID-19 than those with atopic dermatitis (AD) or psoriasis. However, almost all patients showed effective seroconversion after COVID-19 vaccination and only a minority of patients reported increased disease activity.

METHODOLOGY:

• Researchers conducted a substudy of the ongoing Target2B! study involving 424 patients with DIMIDs (mean age, 44 years), including those with AD (n = 176), psoriasis (n = 70), or vitiligo (n = 178).
• Clinical data were collected through standardised electronic case report forms and online patient-reported questionnaires to monitor COVID-19 development, vaccination dates, and disease activity changes.
• SARS-CoV-2 antibodies were measured through IgG titres against the spike protein receptor–binding domain in serum samples at baseline and 28 days after each vaccination. Seroconversion was defined as an antibody concentration > 4 AU/mL.
• Researchers analysed the risk of developing COVID-19 among patients with DIMIDs, the proportion of those achieving seroconversion, and self-reported increases in disease activity after COVID-19 and SARS-CoV-2 vaccination.

TAKEAWAY:

• Patients with vitiligo had a significantly higher incidence of COVID-19 (51.1%) than those with AD (42.0%) or psoriasis (34.3%) (P = .038), with only three patients requiring hospitalisation.
• Almost all patients exhibited effective seroconversion after the first vaccination, with notably higher rates after the second vaccination across all groups: Vitiligo (100%), psoriasis (97.9%), and AD (96.5%).
• Increased disease activity was reported in 6.6% patients with DIMIDs after COVID-19 and in 12.26% after SARS-CoV-2 vaccinations.
• Progressive disease at baseline emerged as the only significant risk factor for increased disease activity after both COVID-19 (odds ratio [OR], 4.27; P = .02) and vaccination (OR, 3.45; P = .002).
• Immunosuppressive therapy was not significantly associated with an increased risk of developing COVID-19 (OR, 1.43; 95% CI, 0.42-5.38; P = .57).

IN PRACTICE:

"No alarming signs were observed in this study regarding the risk of developing (severe) COVID-19 in patients with AD, psoriasis, and vitiligo. Vaccination against COVID-19 is advised in patients with DIMIDs since effective seroconversion levels are reached after regular vaccination regimens. Moreover, patients with DIMIDs can safely continue their immunosuppressant therapy since this does not increase the risk of COVID-19 while vaccination-induced humoral responses were adequate," the authors wrote.

SOURCE:

The study was led by Nicoline F. van Buchem-Post, Netherlands Institute for Pigment Disorders, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands. It was published online on February 14, 2025, in The Journal of Dermatology.

LIMITATIONS:

The study included a control group of individuals who were COVID-19-positive, which hindered risk analysis with the control group. The large heterogeneity in immunosuppressants used and vaccination types prevented detailed statistical analysis. Additionally, self-reporting of disease activity after COVID-19 and vaccination may have resulted in overreporting.

DISCLOSURES:

The study was funded by ZonMw (The Netherlands Organisation for Health Research and Development). One author disclosed receiving grants from ZonMw to study immune response after SARS-CoV-2 vaccination in autoimmune diseases. Another author reported receiving departmental independent research grants and compensation for clinical trials from pharmaceutical industries. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.