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The COVID-19 Pandemic Affects Male Patients With Chronic Spontaneous Urticaria More Than Female Patients
Huzeyfe Kulu1, Mustafa Atasoy1, Kemal Özyurt1
1Urticaria Center of Reference and Excellence (UCARE), Chronic Skin Diseases Unit, Department of Dermatology, Kayseri City Hospital, Kayseri, Turkey.
Insights
The COVID-19 pandemic worsened chronic spontaneous urticaria (CSU) disease activity in male patients, reducing omalizumab efficacy. Female CSU patients and psoriasis patients showed different responses, requiring further investigation.
Area of Science:
- Dermatology
- Immunology
- Public Health
Background:
- The COVID-19 pandemic significantly impacted healthcare delivery for chronic diseases.
- The specific effects of the pandemic on chronic spontaneous urticaria (CSU) and its subgroups remain unclear.
- Understanding these impacts is crucial for managing chronic conditions during health crises.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on disease activity, control, and treatment in CSU patients.
- To compare the pandemic's effects on CSU patients with those of psoriasis patients as a control group.
- To analyze how age, gender, and disease duration influence these pandemic-related changes in CSU patients.
Main Methods:
- A retrospective analysis of 399 patients with CSU or psoriasis.
- Data collected from visits in August 2019 (pre-pandemic) and August 2020 (during pandemic).
- Assessment of changes in disease activity, control, treatment, and omalizumab efficacy, stratified by gender, age, and disease duration.
Main Results:
- Male CSU patients experienced increased disease activity and reduced omalizumab efficacy during the pandemic; female CSU patients did not.
- Psoriasis patients (both male and female) showed increased disease activity and decreased control.
- Omalizumab treatment rates increased in female CSU patients but remained unchanged in males, with efficacy decreasing in males.
Conclusions:
- Male CSU patients experienced a loss of disease control and reduced omalizumab efficacy during the COVID-19 pandemic.
- The distinct impact on male CSU patients warrants further investigation into underlying mechanisms.
- Gender-specific responses highlight the need for tailored management strategies for CSU patients during pandemics.
Introduction:
The COVID-19 pandemic dramatically disrupts health care for patients with chronic diseases including chronic spontaneous urticaria (CSU). As of now, it is unknown if the effects of the pandemic in CSU are different than in other chronic diseases. We also do not know, if different groups of CSU patients, for example female and male patients, are affected differently.
Aim:
To understand how CSU patients and subgroups are affected by the COVID-19 pandemic in their disease activity and control and treatment, using psoriasis as control.
Patients And Methods:
We analyzed 399 patients (450 visits) with CSU or psoriasis assessed during August 2019, i.e. before the pandemic, or August 2020, i.e. during the pandemic, for changes in disease activity, disease control, and the treatment they used, and how these changes are linked to age, gender, and disease duration.
Results:
Male but not female patients with CSU had markedly increased disease activity during the pandemic. CSU patients' age or disease duration were not linked to changes. Male and female patients with psoriasis showed similar increases in disease activity and decreases in disease control. The rate of omalizumab treatment, during the pandemic, was unchanged in male patients and increased in female patients with CSU. The efficacy of omalizumab treatment, during the pandemic, was reduced in male patients but not female patients with CSU.
Conclusion:
Male but not female CSU patients, during the COVID-19 pandemic, show loss of disease control linked to loss of omalizumab efficacy. The reasons for this need to be investigated.
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