Outcomes and risk factors of COVID-19 in patients with bullous pemphigoid: a cross-sectional study

Abstract

Background: The outcomes of coronavirus disease 2019 (COVID-19) in patients with bullous pemphigoid (BP) remain insufficiently understood. This study aimed to evaluate the impact of COVID-19 on BP patients and identify factors influencing the risk and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in BP patients. Methods: A cross-sectional survey was conducted among BP patients in the Department of Dermatology at Shanghai Skin Disease Hospital from December 1, 2022, to March 1, 2023. Participants completed a comprehensive questionnaire addressing demographics, medical conditions, clinical symptoms, and behaviors during the COVID-19 pandemic. Factors influencing the risk of SARS-CoV-2 infection and its severity were evaluated by logistic regression. Results: A total of 96 BP patients were analyzed. Demographic and clinical profiles, COVID-19-related characteristics, and the pandemic’s impact on healthcare-seeking behaviors were described. Our findings showed that vaccination was associated with a reduced risk of SARS-CoV-2 infection (odds ratio [OR]: 0.157, 95% confidence interval [CI]: 0.045–0.552, p=0.002) and infection severity (OR: 0.044, 95% CI: 0.004–0.544, p=0.015). Furthermore, the use of prednisone at a dose >10 mg/day in the last 3 months was associated with an increased risk of SARS-CoV-2 infection (OR: 7.911, 95% CI: 1.379–45.393, p=0.012) but did not appear to influence infection severity. Conclusions: The COVID-19 pandemic posed significant challenges for BP patients. Our study found that the use of prednisone at a dose >10 mg/day in the last three months was associated with an increased risk of SARS-CoV-2 infection. Vaccination provided protection against SARS-CoV-2 infection and severe COVID-19 in BP patients.