IPC recommends that doctors need to carefully weigh the benefit-to-risk ratio of immunosuppressive treatments on an individual basis
Psoriasis is a chronic skin condition that causes red, itchy scaly patches, usually on the knees, elbows, trunk and scalp. The prevalence of psoriasis in India is around 0.44-2.8 per cent and it commonly affects individuals in their third or fourth decade with males being affected 2 times more common than females. With the onset of the COVID-19 pandemic, people with severe psoriasis, like those who are on immunosuppressive therapies or have other medical conditions, are likely to face a higher risk of infection and severe symptoms.
As per the International Psoriasis Council (IPC), with psoriasis who are COVID-19 diagnosed must discuss discontinuing or postponing their use of immunosuppressant medications with their doctor. However, the IPC also recommends that doctors need to carefully weigh the benefit-to-risk ratio of immunosuppressive treatments on an individual basis. It is also not advisable to stop the medications unless there is an active infection.
“It is presently unknown whether psoriasis increases the risk of contracting COVID-19 virus. It’s also currently unclear if having psoriasis increases the risk of having a more severe case of COVID-19. However, there are some factors like age and underlying health conditions like heart diseases, obesity, type 2 diabetes, chronic kidney disease and others that can increase the risk of severe illness or complications if one contracts coronavirus and do develop COVID-19” said Nikkhil K Masurkar, Executive Director of ENTOD Pharmaceuticals.
People with psoriasis usually take medications that can suppress the immune system. As a result, they may be more susceptible to certain infections. The common types of immunosuppressive therapies used for psoriasis include conventional immunosuppressive therapy that makes use of drugs like methotrexate and cyclosporine and Biologic therapy. In Biologic therapy, drugs are used to target and suppress very specific parts of the immune system associated with psoriasis symptoms.
A recent study on people taking immunosuppressive drugs like methotrexate and biologics revealed that the overall rate of hospitalization for individuals taking immunosuppressive drugs was similar to that of the general population. However, there are still limited data on the overall effect of immunosuppressive drugs on the risk of developing serious COVID-19 illness. Research and clinical trials are ongoing to address this very topic.
According Dr Shweta Rajput, MBBS DDV, Disha Skin Institute , Thane West, Medical Consultant, ENTOD Pharmaceuticals, “Psoriasis is an autoimmune disease in which the risk for diabetes, hypertension, chronic lung disease, cardiovascular disease and premature mortality increases with increasing severity of skin disease. Therefore, as a population, patients with psoriasis, especially those with more severe disease, are at risk for worse outcomes from COVID-19. What we do not know about psoriasis treatment and the risk for COVID-19 far outweighs what we do know currently. One model about COVID-19 is that immunosuppression is harmful during the early phases, making a person more susceptible to and at risk for progression of infection with SARS-CoV-2, but immunosuppression may be helpful later in the course of the illness by suppressing the dysregulated immune response in the lungs which can cause acute respiratory distress syndrome and death.”
Even though there’s no specific treatment for coronavirus, but people can reduce their risk of contracting it by maintaining physical distance from others, avoiding unnecessary public outings, and practicing good hygiene. Those with psoriasis should speak to their doctor about their specific case. Only a doctor can address any concerns that a person has, and they may adjust their treatment plan accordingly.