Patients with autoimmune bullous skin diseases (AIBD) treated with rituximab have an increased risk for COVID-19 infection, according to a research letter published online Oct. 26 in the Journal of the American Academy of Dermatology.

Pascal Joly, M.D., Ph.D., from Rouen University Hospital in France, and colleagues examined COVID-19 severity and mortality among patients with AIBD in a study performed in 49 dermatology departments in 12 regions of France.

The researchers found that 59 of the 5,180 patients with AIBD were diagnosed with possible, probable, or confirmed COVID-19, and of these patients, 50.8, 11.9, and 25.4 percent were hospitalized, admitted to an intensive care unit, and died, respectively. For patients treated with rituximab, the incidence ratio of COVID-19 ranged from 3.62 (95 percent confidence interval, 1.29 to 8.85) to 5.37 (95 percent confidence interval, 3.15 to 8.96) for AIBD patients hospitalized with a confirmed diagnosis of COVID-19 and for those with a confirmed, probable, or possible diagnosis of COVID-19 infection. Compared with the general population, lethality of hospitalized confirmed COVID-19 was 1.63-fold higher in patients with AIBD (95 percent confidence interval, 0.83 to 2.55; P = 0.13). Patients with AIBD and COVID-19 had a higher three-month death risk than those with AIBD without COVID-19 (5.9-fold; 95 percent confidence interval, 3.9 to 8.4).

"This study showed that treatment with rituximab is a major risk factor of COVID-19 infection," the authors write. "Given the high lethality of COVID-19 in patients with AIBD, physicians should carefully evaluate the benefit-risk balance of rituximab therapy during this pandemic period."

Two authors disclosed financial ties to the pharmaceutical industry.

Abstract/Full Text