LB761 Clinical outcomes in Pemphigoid and Pemphigus patients with COVID-19

Pakhchanian, H.; Raiker, R.; Wang, J.; Phan, K.

Pemphigoid and Pemphigus are both blistering autoimmune skin diseases that can have systemic manifestations. Little information exists on the outcomes of COVID patients with these blistering diseases, so the goal was to investigate the impact of both on COVID outcomes. A retrospective cohort study was done using TriNetX, a federated real time database of 63 million records. COVID patient cohorts were identified by validated ICD-10 and serology codes per CDC guidelines from 1/20/2020 to 2/5/2021. A 1:1 matched propensity score analysis was conducted, adjusting for comorbidities and demographics, to calculate adjusted Risk Ratios (aRR) with 95% CI. 30-day COVID outcomes were examined with severe COVID being defined as a composite of mortality and ventilation. Subgroup analyses were also performed for pemphigoid and pemphigus patients on systemic immunosuppressants. In a matched sample of 260 patients in each cohort, there was no significant difference between pemphigus/pemphigoid-COVID patients and non-pemphigus/pemphigoid COVID patients in hospitalization (1.1[0.85-1.43]), acute respiratory distress syndrome (1.1[0.47-2.5]), mechanical ventilation (1.64[0.8-3.4]), mortality (1.75[0.9-3.5]), and severe COVID (1.53[0.9-2.7]) but pemphigus/pemphigoid patients were at a higher risk for sepsis (1.87[1.1-3.4]). Subgroup analysis revealed that pemphigus/pemphigoid-COVID patients with a one-year history of immunosuppressants had no difference in complication risk compared to pemphigus/pemphigoid-COVID patients without one year history of immunosuppressants. Overall pemphigus/pemphigoid-COVID patients are not at higher risks for severe COVID complications compared to COVID patients without pemphigus/pemphigoid. History of systemic Immunosuppressants also do not increase complication risk in pemphigus/pemphigoid patients. Additional research is needed to examine the long term impacts.