Study finds factors linked to COVID-19 severity in patients with psoriasis, psoriatic arthritis, and axial spondyloarthritis

A study based on COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries have identified the risk factors associated with COVID-19 severity in patients with psoriasis (PsO), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA).  The noted risk factors are older age, male gender, increased disease activity, comorbidity, and glucocorticoid intake. The study findings are published in the recent issue of the Annals of Rheumatic Diseases.

Pedro M Machado and co-researchers analyzed the demographic data, clinical features, and COVID-19 outcomes of 5045 patients. They found that male sex, older age, cardiovascular, respiratory, renal, metabolic, and cancer comorbidities, and intake of glucocorticoids were linked to an increased risk of severe COVID-19. During the late pandemic periods, PsO and exposure to TNFi, IL17i, and IL-23i/IL-12+23i were found to be linked to less severity of COVID-19.

Mahil et al. (2021) also found that older age, male gender, nonwhite ethnicity, and comorbid chronic lung disease were linked to a higher risk of COVID-19-related hospitalization in PsO patients. The study assessed the data of 374 PsO patients, including those receiving biological or systemic treatment. Compared to the PsO patients who received biologics, patients who underwent nonbiologic systemic therapy reported higher hospitalization rates.

A 2022 study found a better outcome of COVID-19 in PsA patients who received methotrexate and biological disease-modifying antirheumatic drugs. The experts reported similar COVID-19 severity In both rheumatoid arthritis and PsA patients,. Hence, the use of biologic systemic therapy was found to reduce COVID-19 severity in these patients. However, this study also reported age as a risk factor for poor COVID-19 outcomes in PsA patients.

Identifying the risk factors linked to COVID-19 severity for the general population and patients with PsO, PsA, and axSpA is beneficial for clinicians and scientific communities to plan and customize risk management strategies during COVID-19 or similar pandemics.


  1. Machado PM, Schafer M, Mahil SK, Liew J, Gossec L, Dand N, et al. Characteristics associated with poor COVID-19 outcomes in people with psoriasis, psoriatic arthritis and axial spondyloarthritis: data from the COVID-19 PsoProtect and Global Rheumatology Alliance physician-reported registries. Ann Rheum Dis. 2023 Feb 14:ard-2022-223499.
  2. Mahil SK, Dand N, Mason KJ, Yiu ZZN, Tsakok T, Meynell F, et al. Factors associated with adverse COVID-19 outcomes in patients with psoriasis-insights from a global registry-based study. Journal of Allergy and Clinical Immunology. 2021 Jan 1;147(1):60–71.
  3. Savio V, Maldini C, Alba P, Saurit V, Berbotto G, Pisoni C, et al. Is Psoriatic Arthritis a Risk Factor for Severe Covid -19 Infection? Data from the Argentinian Registry Sar-Covid. Annals of the Rheumatic Diseases. 2022 Jun 1;81(Suppl 1):927–8.