key: cord-1017497-olrf7ncx
authors: Zhang, Junfen; Loman, Laura; Kamphuis, Esmé; Schuttelaar, Marie L.A.; Boezen, H. M.; Mierau, Jochen O.; Franke, H. Lude; Dekens, Jackie; Deelen, Patrick; Lanting, Pauline; Vonk, Judith M.; Nolte, Ilja; Ori, Anil P.S.; Claringbould, Annique; Boulogne, Floranne; Dijkema, Marjolein X.L.; Wiersma, Henry H.; Warmerdam, Robert; Jankipersadsing, Soesma A.; van Blokland, Irene
title: Impact of the COVID-19 pandemic on adults with moderate-to-severe atopic dermatitis in the Dutch general population
date: 2021-12-28
journal: JAAD Int
DOI: 10.1016/j.jdin.2021.12.006
sha: a587d524dab2ce27b98d9cdae4b14548a293c188
doc_id: 1017497
cord_uid: olrf7ncx

nan

To the Editor: The COVID-19 pandemic might disproportionately impact patients with atopic 46 dermatitis (AD), a chronic inflammatory disorder with immune dysregulation. Here, we 47 conducted a large cross-sectional study to investigate associations between COVID-19-48 related impact and AD severity among adults in the Dutch general population. 49 This study was conducted within the Lifelines Cohort Study 1 , a multi-disciplinary 50 prospective population-based cohort study examining, in a unique three-generation design, 51 the health and health-related behaviors of 169 729 persons living in the north of the 52 Netherlands. All procedures were approved by the medical ethics committee, and all 53 subjects provided written informed consent. AD-related data was collected by sending out a 54 digital questionnaire to all adult participants of the Lifelines Cohort Study (N=135 950) 55 between February and May 2020 (response rate: 42.4%) 2 . Definitions of AD have been 56 described previously 2 . COVID-19-related variables were collected by sending out a series of 57 COVID-19 questionnaires (weekly between March and May 2020, biweekly until July 2020, 58 and then at monthly intervals until July 2021) to the adult participant of the Lifelines Cohort 59 Study (N=139 735) 3 , of those 76 377 (54.7%) responded to at least one questionnaire. The 60 selection of COVID-19 questionnaires varied across outcome measures of COVID-19-related 61 variables. The COVID-19 infection rate, COVID-19 vaccination coverage and side effects were 62 based on combined answers from all available questionnaires; lung disease, body mass index 63 (BMI), smoking habits and information regarding precautions taken, were collected from the 64 first COVID-19 questionnaire, which was sent out at the same period of AD questionnaire.

respectively. Associations between AD severity and COVID-19-related impact were analyzed using binary logistic regression models. 70 A total of 53 545 subjects, who responded to at least one COVID-19 questionnaire and 71 responded to the AD questionnaire, were included (Table 1) . Non-responders were younger, 72 and more often males (data not shown). In the multivariate analysis (Table 2) , both mild AD 73 and moderate-to-severe showed a positive association with a higher prevalence of lung 74 disease (mild AD: adjusted odds ratio (aOR) 2.50, 95% confidence interval (CI) 1.89-3.30; 75 moderate-to-severe AD: aOR 3.19, 95% CI 2.68-3.80). All groups had similar COVID-19 76 infection rates. Subjects with AD, regardless of disease severity, compared with non-AD, 77 were more concerned about the COVID-19 crisis (mild AD: aOR 1.06, 95% CI 1.00-1.12; 78 moderate-to-severe AD: aOR 1.08, 95% CI 1.04-1.12) and more often chose not to contact a 79 doctor when having health problems (mild AD: aOR 2.52, 95% CI 1. 35-4.67; moderate-to-80 severe AD: aOR 2.43, 95% CI 1.59-3.71). Subjects with mild AD, but not moderate-to-severe 81 AD, compared with non-AD, had a higher COVID-19 vaccination rate (aOR 1.44, 95% CI 1.01-82 2.05) and more frequently covered mouth and nose in public (aOR, 1.93, 95% CI 1.25-3.00). 83 Moreover, only subjects with moderate-to-severe AD compared with non-AD, estimated a 84 higher chance of becoming infected (aOR 1.53, 95% CI 1.00-2.35) and expected a more results from the Lifelines Cohort Study. J Eur Acad Dermatol Venereol. June 2021. 

Cohort Profile: LifeLines, a three-generation

Level of concerns about the corona crisis (1-10, mean ± SD) Missing, n Quality of life (1-10, mean ± SD) Missing, n