Editor,Rapid online surveys may help illuminate patient perspectives about the SARS‐COV‐2 virus and the COVID‐19 pandemic, allowing clinicians to address these concerns.
To understand patient perspectives during the early phases of the COVID‐19 pandemic, the National Psoriasis Foundation (NPF) conducted a two‐wave survey of a random stratified sample of individuals 18 years of age or older with psoriatic disease in the United States who recently contacted the NPF. In April and June 2020, the following questions assessed patient perspectives (IRB‐approved by Genetic Alliance):How concerned are you (1, not at all concerned – 5, very concerned), if at all, that the current treatment(s) you take for your PsO/PsA may:Increase your risk of becoming infected with COVID‐19?Cause you to have a worse outcome if you were to become infected with COVID‐19?Has your healthcare provider discussed any risks associated with:Your PsO/PsA and COVID‐19? (Y/N).The treatments for your PsO/PsA and COVID‐19? (Y/N).How much of a threat, if any, do you feel the COVID‐19 pandemic represents to your personal health? (1, not at all – 5, extremely serious threat).Of the 8398 surveys sent out, 263 were completed. Respondents were mostly female (84%) and white (88%), older (mean age = 53.6), 57.8% with PsO/PsA, 4.9% with PsA alone, 37.3% with PsO alone, and 54.4% had previously used biologics. Few reported their HCP discussed the impact of having PsO/PsA (18.6%) or PsO/PsA treatments (20.2%) on COVID‐19 infection risk. Increased perception of COVID‐19 as a threat to personal health was associated with disease type but not treatment type. Individuals with PsA perceived COVID‐19 as a higher threat to their personal health than patients with PsO alone (baseline F(1, 259) = 7.12, P < 0.05, and follow‐up F(1, 252) = 7.83, P ≤ 0.05; one‐way ANOVA results). Past biologic use did not affect perceived threat of COVID‐19 on personal health (baseline, P = 0.104; follow‐up P = 0.160).Biologic users were, however, more concerned treatments may increase risk of COVID‐19 infection at baseline (M = 3.78, SD = 1.23 vs. M = 2.28, SD = 1.41; t(260) = −9.11, P ≤ 0.001) and follow‐up (M = 3.45, SD = 1.40 vs. M = 2.12, SD = 1.40; t(252) = −7.53, P ≤ 0.001) and contribute to worse COVID‐19 outcomes at baseline (M = 4.03, SD = 1.20 vs. M = 2.39, SD = 1.44; t(259) = −9.84, P ≤ 0.001) and follow‐up (M = 3.60, SD = 1.41 vs. M = 2.21, SD = 1.43; t(252) = −7.77, P ≤ 0.001; two‐tailed independent sample t‐tests). Among all respondents, concerns about treatments decreased at follow‐up:Increase risk of COVID‐19 due to PsO/PsA or its treatments?(M = 3.10, SD = 1.51 vs. M = 2.85, SD = 1.55, t(263) = 3.04, P ≤ 0.001).Worsen outcomes if infected due to PsO/PsA or its treatments?(M = 3.10, SD = 1.51 to M = 2.85, SD = 1.55, t(263) = 3.04, P ≤ 0.001; paired samples t‐test).In summary, in two surveys administered early in the COVID‐19 pandemic, US patients with psoriatic disease reported that few COVID‐19‐related discussions had occurred between them and their HCP. Respondents with PsA and biologic users reported a greater concern that treatments increase risk of SARS‐CoV‐2 infection and may cause worse COVID‐19 outcomes. These survey results resemble comparable studies,
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suggesting patients are concerned how treatments and disease status may influence risk of COVID‐19 infection and outcomes. Guidance on managing psoriatic disease during the COVID‐19 pandemic published by the NPF may improve patient‐provider communication about these important topics.
,Low‐survey completion rate and a sample consisting of individuals engaged with a patient advocacy organization may contribute to selection bias. The COVID‐19 pandemic could have increased barriers to e‐mail communication, contributing to the lack of communication between patients and HCPs. Treatment status was also not objectively defined. Lastly, survey items had not undergone psychometric testing, and the survey sample may not be representative of the estimated psoriatic patient population.
Funding sources
The studies were funded by the National Psoriasis Foundation.
Conflicts of interest
George Gondo, Dr. Stacie Bell, Jane Slayden and Georgia Ullmann are employees of the National Psoriasis Foundation. Dr. Andy Blauvelt has served as a consultant and investigator for AbbVie, Almirall, Arena, Athenex, Boehringer Ingelheim, Bristol‐Myers Squibb, Dermavant, Eli Lilly and Company, Evommune, Forte, Galderma, Incyte, Janssen, Leo, Novartis, Pfizer, Rapt, Regeneron, Sanofi Genzyme, Sun Pharma, and UCB Pharma.