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            <funder>The PSOBIOTEQ cohort study is supported by unrestricted research grants from the French Ministry of Health (PHRC AOM 09 195), the French National Drug and Healthcare Products Safety Agency (ANSM) and private funders (AbbVie, Janssen, Pfizer, MSD France, Lilly France, Novartis Pharma, Celgene, Amgen and LEO Pharma). None of the private funders had any role in the design of this ancillary study, in the management, analysis and interpretation of the data, in the preparation or approval of this manuscript, or in the decision to submit it for publication. They received the manuscript for information purposes before submission.The study was sponsored by the Centre for Clinical Research and Innovation (DRCI, AP-HP, Direction de la Recherche Clinique et de l’Innovation, Assistance Publique–Hôpitaux de Paris). The PSOBIOTEQ cohort was set up under the auspices of the French Society of Dermatology (SFD) and its Psoriasis Research Group.</funder>
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                <term xml:lang="en">Biologic drug</term>
                <term xml:lang="en">COVID-19</term>
                <term xml:lang="en">Psoriasis</term>
                <term xml:lang="en">SARS-CoV-2</term>
                <term xml:lang="en">Supprimer systemic therapy</term>
                <term xml:lang="en">Treatment compliance</term>
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              <classCode scheme="halDomain" n="sdv">Life Sciences [q-bio]</classCode>
              <classCode scheme="halDomain" n="sdv.mhep.derm">Life Sciences [q-bio]/Human health and pathology/Dermatology</classCode>
              <classCode scheme="halDomain" n="sdv.mhep.mi">Life Sciences [q-bio]/Human health and pathology/Infectious diseases</classCode>
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              <p>BACKGROUND: The nature of the COVID-19 pandemic led to concerns among patients and physicians about the potential impact of immunosuppressive treatments for chronic diseases such as psoriasis on the risk of severe COVID-19. OBJECTIVES: To describe treatment modifications and determine the incidence of COVID-19 infection among psoriasis patients during the first wave of the pandemic, and identify the factors associated with these events. METHODS: Data from PSOBIOTEQ cohort relating to the first COVID-19 wave in France (March to June, 2020), as well as a patient-centred COVID-19 questionnaire, were used to evaluate the impact of lockdown on changes (discontinuations, delays or reductions) in systemic therapies, and to determine the incidence of COVID-19 cases among these patients. Logistic regression models were used to assess associated factors. RESULTS: Among the 1751 respondents (89.3%), 282 patients (16.9%) changed their systemic treatment for psoriasis, with 46.0% of these changes being initiated by the patients themselves. Patients were more likely to experience psoriasis flare-ups during the first wave if they changed their treatment during this period (58.7% vs 14.4%; P &amp;lt; 0.0001). Changes to systemic therapies were less frequent among patients with cardiovascular diseases (P &amp;lt; 0.001), and those aged ≥ 65 years (P = 0.02). Overall, 45 patients (2.9%) reported having COVID-19, and eight (17.8%) required hospitalization. Risk factors for COVID-19 infection were close contact with a positive case (P &amp;lt; 0.001) and living in a region with a high incidence of COVID-19 (P &amp;lt; 0.001). Factors associated with a lower risk of COVID-19 were avoiding seeing a physician (P = 0.002), systematically wearing a mask during outings (P = 0.011) and being a current smoker (P = 0.046). CONCLUSIONS: Discontinuation of systemic psoriasis treatments during the first COVID-19 wave (16.9%) - mainly decided by patients themselves (46.0%) - was associated with a higher incidence of disease flares (58.7% vs 14.4%). This observation and factors associated with a higher risk of COVID-19 highlight the need to maintain and adapt patient-physician communication during health crises according to patient profiles, with the aim of avoiding unnecessary treatment discontinuations and ensuring that patients are informed about the risk of infection and the importance of complying with hygiene rules.</p>
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