Methotrexate use associated with COVID-19 hospitalization in
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COVID-19-associated hospitalization was more common in patients who were taking oral methotrexate but not in those taking biologics, according to a study.

The impact of immune-related conditions on the outcomes of COVID-19 is poorly understood. Determinants of COVID-19 outcomes among patients with psoriasis are yet to be established.

Th objective of this study was to characterize a large cohort of patients with psoriasis with COVID-19 and to identify predictors of COVID-19-associated hospitalization and mortality.

A population-based nested case-control study was performed using the computerized database of Clalit Health Services, Israel. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence (CIs) of predictors for COVID-19-associated hospitalization and mortality.

-- The study population included 3151 patients with psoriasis who tested positive for COVID-19.

-- Subclinical COVID-19 infection occurred in 2818 (89.4%) of the patients while 122 (3.9%), 71 (2.3%), 123 (3.9%), and 16 (0.5%) of the patients experienced a mild, moderate, severe, and critical disease, respectively.

-- Overall, 332 (10.5%) patients were hospitalized and 50 (1.6%) patients died because of COVID-19 complications. Intake of methotrexate independently predicted COVID-19-associated hospitalization.

-- Use of biologic agents was not associated with COVID-19-associated hospitalization or mortality.

-- Older age, the presence of comorbid cardiovascular diseases, metabolic syndrome, chronic obstructive pulmonary disease, and chronic renal failure independently predicted both COVID-19-associated hospitalization and mortality.

Conclusively, the use of oral methotrexate was associated with an increased odds of COVID-associated hospitalization, whereas the use of biologic drugs was not associated with worse outcomes of COVID-19 among patients with psoriasis.

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