COVID-19 is the illness that’s caused by the 2019 coronavirus, SARS-CoV-2.

Most cases of COVID-19 are mild. However, some of them can be severe, requiring oxygen therapy, mechanical ventilation, and other lifesaving medical techniques.

People with certain health conditions who contract the 2019 coronavirus are at an increased risk for severe illness if they develop COVID-19.

If you have psoriasis, you may be wondering what effect COVID-19 may have on you and your treatment plan.

Keep reading to learn more about:

  • how COVID-19 affects people with psoriasis
  • preventive steps that you can take
  • what to do if you become ill

We’re still learning more and more about COVID-19 every day.

It’s currently unknown if having psoriasis increases your risk of contracting the 2019 coronavirus, which can lead to the development of COVID-19.

It’s also currently not known if having psoriasis increases your risk of having a more severe case of COVID-19, should you develop it, after contracting the 2019 coronavirus.

However, there are some factors that are known to increase the risk of severe illness or complications if you contract the new coronavirus and do develop COVID-19.

Advanced age

According to the Centers for Disease Control and Prevention (CDC), the risk of severe illness or complications due to COVID-19 increases with age.

For example, someone in their 60s is at a higher risk for serious illness than someone in their 50s. Adults ages 85 and older are at the highest risk.

Underlying health conditions

According to recent data, the CDC has identified the following health conditions as risk factors for severe illness or complications if you develop COVID-19:

Many people with psoriasis take medications that can suppress the immune system. Because of this, they may be more susceptible to certain infections. The types of immunosuppressive therapies used for psoriasis include:

  • Conventional immunosuppressive therapy. This type of therapy uses drugs that broadly suppress the immune system, helping to curb psoriasis symptoms. Some examples include methotrexate and cyclosporine.
  • Biologic therapy. Biologics are drugs that target and suppress very specific parts of the immune system associated with psoriasis symptoms. Examples of biologics include but aren’t limited to etanercept (Enbrel), adalimumab (Humira), and ustekinumab (Stelara).

So what do we know about these medications and COVID-19 right now? A recent small case study of people taking immunosuppressive drugs such as methotrexate and biologics found that:

  • In total, 14 out of 86 study participants were hospitalized. As of the publication date, 11 of them had been discharged.
  • Of the hospitalized participants, the percentage of those taking biologics (50 percent) was comparable to that of those taking methotrexate (43 percent).
  • The overall rate of hospitalization for individuals taking immunosuppressive drugs was similar to that of the general population.

However, there’s still limited data on the overall effect that immunosuppressive drugs have on the risk of serious COVID-19 illness. Studies and clinical trials are ongoing to address this very topic.

Current recommendations

The American Academy of Dermatology (AAD) currently recommends that people taking immunosuppressive drugs should continue taking them as directed unless they have symptoms of COVID-19 or have tested positive.

The CDC also recommends that you maintain at least a 30-day supply of any prescription drug that you take, including immunosuppressive drugs. This can help protect against running out of your psoriasis medication during the pandemic.

If you’re currently taking immunosuppressive drugs for psoriasis and have questions or concerns related to COVID-19, don’t hesitate to speak with your doctor.

They can help by providing you with additional information and guidance.

Below, we’ll break down some important things to know if you have psoriasis and test positive for COVID-19.

General steps to take

If you test positive for COVID-19, take the following steps:

  • Stay home. Plan to remain in your home, only leaving to seek medical care. If you live with other people, try to isolate yourself by using a separate bedroom and bathroom, if possible.
  • Contact your doctor. Let them know that you’ve tested positive for COVID-19. Be sure to discuss your symptoms, how you can ease them, and any medications you’re taking. Many providers are offering telehealth appointments in lieu of in-person visits during the pandemic.
  • Take care of yourself. Follow your doctor’s guidance on how to care for yourself while you’re ill.
  • Track your symptoms. Carefully keep track of your symptoms. If they begin to worsen, don’t hesitate to seek medical care.

Specific guidance for people with psoriasis

If you have psoriasis and have tested positive for COVID-19 or have COVID-19 symptoms, the International Psoriasis Council (IPC) recommends that you stop taking immunosuppressive medications until you fully recover.

This recommendation is in line with preestablished guidelines from both the AAD and the European Dermatology Forum (EDF). These guidelines state that immunosuppressive medications shouldn’t be used during an active infection.

Treating a mild case of COVID-19

Most cases of COVID-19 are mild and can be treated at home.

While fever, cough, and shortness of breath are often associated with COVID-19, according to the CDC the following symptoms are most common in COVID-19 cases that don’t require hospitalization:

While there’s currently no specific treatment that’s approved for COVID-19, there are steps that you can take at home to help ease the symptoms of a mild case:

  • Get rest. Staying well rested can help your body fight the infection.
  • Stay hydrated. Drinking plenty of water can help to prevent dehydration.
  • Use over-the-counter (OTC) medications. OTC medications like acetaminophen (Tylenol) can help to relieve symptoms like fever, headache, and sore throat.

When to seek care for COVID-19

There are some warning signs that COVID-19 illness has become more severe. If you experience any of the following symptoms, call 911 and explain the situation:

Healthline

The National Psoriasis Foundation (NPF) encourages people with psoriasis to follow the CDC and the World Health Organization (WHO) guidelines to help prevent contracting the 2019 coronavirus and becoming ill with COVID-19.

These include things like:

  • Regular handwashing. Wash your hands frequently with soap and water. If this isn’t available, use a hand sanitizer with at least 60 percent alcohol. Avoid touching your nose, mouth, or eyes if your hands aren’t clean.
  • Social (physical) distancing. Try to limit your contact with people outside your household. If you’re going to be around others, aim to stay at least 6 feet (2 meters) apart.
  • Face coverings, such as masks. Face coverings can help limit the transmission of COVID-19. If you’re going to be around others, wear a cloth face covering that covers both your nose and mouth.
  • Disinfecting. Regularly disinfect high-touch surfaces within your home. Examples include doorknobs, appliance handles, and TV remotes.
  • Staying healthy. Continue to take steps to promote your overall health. Examples include getting regular exercise, eating a healthy diet, and managing stress.

Increased stress is associated with psoriasis flares. In this way, the COVID-19 pandemic may place an extra burden on the mental health of people with psoriasis.

A 2020 study of 926 people with psoriasis found that 43.7 percent of participants reported a moderate to severe exacerbation of their symptoms. This effect was associated with factors like lost income and outdoor activity restrictions due to the pandemic.

Psoriasis flares have even been reported following a COVID-19 infection.

So what are some ways that can help you reduce your stress levels during the COVID-19 pandemic? Try some of the suggestions below:

  • Limit your news intake. While it can be tempting to refresh your news feed often, try to avoid doing so. Constant exposure to news media can increase your levels of stress or anxiety about the pandemic.
  • Keep a routine. Aim to stay on a regular schedule for things like meals, bedtimes, and work. This can help you by making you feel more in control. Consider these tips to kick-start a routine.
  • Stay busy. Try to keep yourself busy, whether it’s through work, an activity you really enjoy, or both. Doing so can help take your mind off of current events.
  • Get regular exercise. Not only is exercise good for your overall health, but it can also help lift your mood.
  • Try to relax. There are many activities that can promote relaxation. Some that you can try out include yoga, meditation, or breathing exercises.
  • Link up with others. Having a support network is important in managing stress. It’s still possible to connect with others in the age of social distancing. Video chats, phone calls, and text messaging can all help you interact with your friends and family.

Psoriasis medications being tested for the treatment of COVID-19

The biologics that are used to treat psoriasis work to lower the levels of chemicals known as cytokines. Increased levels of certain cytokines are associated with inflammation in the body.

Some of the types of cytokines targeted by biologics include:

  • Tumor necrosis factor alpha (TNF-a): Etanercept (Enbrel), adalimumab (Humira), infliximab (Remicade)
  • Interleukin-23 (IL-23): Guselkumab (Tremfya) and tildrakizumab (Ilumya)
  • Interleukin-12 (IL-12) and IL-23 together: Ustekinumab (Stelara)
  • Interleukin-17 (IL-17): Secukinumab (Cosentyx), ixekizumab (Taltz), brodalumab (Siliq)

An increase of the cytokines above is associated with the symptoms of psoriasis.

Additionally, overproduction of some of these cytokines, such as IL-17 and TNF-a, is also associated with severe COVID-19 illness.

Because of this, drugs that affect the levels of these cytokines are being investigated as potential COVID-19 treatments.

However, it’s important to note that it’s still unknown how these drugs will affect the course of COVID-19 illness.

Healthline

Data is currently limited on whether having psoriasis increases your risk of severe illness if you contract the 2019 coronavirus and develop COVID-19.

Similarly, we’re still learning about the effect of immunosuppressive medications, such as biologics, on COVID-19 risk and illness.

If you have psoriasis and don’t have symptoms of COVID-19, continue taking your medications as directed. Talk with your doctor if you have any questions or concerns about your medications and COVID-19.

If you test positive for the 2019 coronavirus or have COVID-19 symptoms, isolate yourself at home and contact your doctor.

It’s recommended that you stop taking your psoriasis medications until you fully recover. Continue to monitor your symptoms and seek immediate care if they begin to worsen.

The COVID-19 pandemic can be stressful, which can increase your risk for a psoriasis flare.

Try to keep your stress levels down by doing things like:

  • limiting exposure to news media
  • staying busy
  • connecting with friends and family