Psoriasis and COVID-19: a narrative review

Since its emergence in December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has infected millions of people worldwide, directly causing poor health and deaths. Its wider impact is equally devastating, ranging from overstretched health services and reduced healthcare access, to the psychosocial and economic efects of lockdowns and social distancing, posing risks of indirect excess morbidity and mortality.^1–3

The pandemic has disproportionately impacted certain populations including the elderly, non-white ethnic groups and those with comorbidities.^4,5 At the outset of the pandemic, there was an immediate concern that people with psoriasis may be at potential risk of poor COVID-19 outcomes due to the disease itself, its associated multimorbidities (cardiovascular, metabolic, and hepatic diseases), or its treatment. Many patients with psoriasis receiving standard systemic immunosuppressants or targeted biologic therapies were also classifed as ‘clinically extremely vulnerable’ and advised to shield by Public Health England (PHE).⁶ Multiple studies have since been undertaken to understand the impact of the current pandemic on people with psoriasis.

This article reviews the evidence on COVID-19 in the context of psoriasis. It discusses risk factors for adverse COVID-19 outcomes, treatment-related risks and the impact of the COVID-19 pandemic on people with psoriasis.