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\begin{document}

\title{Management of patients with atopic dermatitis undergoing systemic
therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19
registry}



\author[1]{Andrea Chiricozzi}%
\author[2]{Marina Talamonti}%
\author[3]{Clara De Simone}%
\author[2]{Marco Galluzzo}%
\author[1]{Niccolò Gori}%
\author[4]{Gabriella Fabbrocini}%
\author[5]{Angelo Marzano}%
\author[6]{Giampiero Girolomoni}%
\author[7]{Anna Maria Offidani}%
\author[8]{Maria Teresa Rossi}%
\author[2]{Luca Bianchi}%
\author[9]{Antonio Cristaudo}%
\author[10]{Maria Teresa Fierro}%
\author[11]{Luca Stingeni}%
\author[12]{Giovanni Pellacani}%
\author[13]{Giovanni Argenziano}%
\author[14]{Annalisa Patrizi}%
\author[15]{Paolo Pigatto}%
\author[16]{Marco Romanelli}%
\author[17]{Paola Savoia}%
\author[18]{Pietro Rubegni}%
\author[19]{Caterina Foti}%
\author[20]{Nicola Milanesi}%
\author[21]{Anna Belloni Fortina}%
\author[22]{Maria Rita Bongiorno}%
\author[23]{Teresa Grieco}%
\author[24]{Sergio Di Nuzzo}%
\author[25]{Maria Concetta Fargnoli}%
\author[26]{Andrea Carugno}%
\author[27]{Alberico Motolese}%
\author[28]{Franco Rongioletti}%
\author[29]{Paolo Amerio}%
\author[30]{Riccardo Balestri}%
\author[31]{Concetta Potenza}%
\author[32]{Giuseppe Micali}%
\author[33]{Cataldo Patruno}%
\author[34]{Iris Zalaudek}%
\author[35]{Maurizio Lombardo}%
\author[24]{Claudio Feliciani}%
\author[36]{Fabrizio Guarneri}%
\author[1]{Ketty Peris}%
\affil[1]{Fondazione Policlinico Universitario A. Gemelli IRCCS}%
\affil[2]{Policlinico Tor Vergata, Department of Systems Medicine, Tor Vergata University of Rome}%
\affil[3]{ Fondazione Policlinico Universitario A. Gemelli IRCCS}%
\affil[4]{Section of Dermatology }%
\affil[5]{Università degli Studi di Milano, UOC Dermatologia, IRCCS Fondazione Cà Granda Ospedale Maggiore Policlinico}%
\affil[6]{University of Verona, Italy}%
\affil[7]{Polytechnic University of the Marche Region}%
\affil[8]{ASST Spedali Civili of Brescia, University of Brescia}%
\affil[9]{San Gallicano Dermatological Institute IRCCS}%
\affil[10]{University of Turin}%
\affil[11]{Section of Clinical, Allergological and Venereological Dermatology}%
\affil[12]{University of Modena and Reggio Emilia}%
\affil[13]{University of Campania, Naples}%
\affil[14]{University of Bologna}%
\affil[15]{University of Milan}%
\affil[16]{University of Pisa}%
\affil[17]{Amedeo Avogadro University of Eastern Piedmont}%
\affil[18]{University of Siena}%
\affil[19]{Unit of Dermatology, University of Bari}%
\affil[20]{University of Florence}%
\affil[21]{University of Padova, Padova, Italy}%
\affil[22]{University of Palermo}%
\affil[23]{Università degli Studi di Roma La Sapienza}%
\affil[24]{University of Parma}%
\affil[25]{University of L'Aquila Department of Clinical Sciences and Applied Biotechnology}%
\affil[26]{ASST Papa Giovanni XXIII Hospital}%
\affil[27]{Arcispedale Santa Maria Nuova-IRCCS di Reggio Emilia}%
\affil[28]{University of Cagliari}%
\affil[29]{Gabriele d'Annunzio University of Chieti and Pescara Department of Sciences}%
\affil[30]{Santa Chiara Hospital}%
\affil[31]{Sapienza University of Rome - Polo Pontino}%
\affil[32]{University of Catania}%
\affil[33]{Università degli Studi di Catanzaro Magna Graecia Facoltà di Medicina e Chirurgia}%
\affil[34]{University of Trieste Clinical Department of Medical Surgical and Health Sciences}%
\affil[35]{ASST Sette Laghi, Ospedale di Circolo}%
\affil[36]{University of Messina Faculty of Medicine and Surgery}%


\vspace{-1em}



  
  \date{May 25, 2024}


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\selectlanguage{english}
\begin{abstract}
Background: Few and small studies have described the management of
immunomodulant/immunosuppressive therapies or phototherapy in atopic
dermatitis (AD) patients during coronavirus disease 2019 (COVID-19)
pandemic. Methods: A national registry, named DA-COVID-19 and involving
35 Italian dermatology units, was established in order to evaluate the
impact of COVID-19 pandemic on the management of adult AD patients
treated with systemic immunomodulant/immunosuppressive medications or
phototherapy. Demographic and clinical data were obtained at different
timepoints by teledermatology during COVID-19 pandemic, when regular
visits were not allowed due to sanitary restrictions. Disease severity
was assessed by both physician- and patient-reported assessment scores
evaluating itch intensity, sleep disturbances, and AD severity. Results:
A total of 1831 patients were included, with 1580/1831 (86.3\%)
continuing therapy during pandemic. Most patients were treated with
dupilumab (86.1\%, 1576/1831) that was interrupted in only 9.9\%
(156/1576) of cases, while systemic immunosuppressive compounds were
more frequently withdrawn. Treatment interruption was due to decision of
the patient, general practitioner or dermatologist in 39.9\% (114/286),
5.6\% (16/286), and 30.1\% (86/286) of cases, respectively. Fear of
increased susceptibility to SARS-CoV-2 infection (24.8\%, 71/286) was
one of the main causes of interruption. Sixteen patients (0.9\%)
resulted positive to SARS-CoV-2 infection, 3 of them (0.2\%) were
hospitalized but no cases of COVID-related death occurred. Conclusions:
Most AD patients continued systemic treatments during COVID pandemic and
lockdown period, without high impact on disease control, particularly
dupilumab-treated patients.%
\end{abstract}%



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