COVID-19 symptom severity
We calculated the distribution of COVID-19 symptom severity across groups in six categories: 0/“asymptomatic,” 1/“mild,” 2/“moderate,” 3/“severe,” 4/“very severe,” and 5/“fatal” (Table 1B). Our initial analysis focused on the entire cohort of patients, agnostic to laboratory evidence of COVID-19 infection. Treatment groups were compared to determine the proportions of patients in each symptom category (Figure 1). Given the potential for multiple confounders and risk factors for symptomatic infection (Table 1A),32we adjusted for known risk factors for increased COVID-19 morbidity (e.g., obesity, hypertension, etc.) using logistic regression models. We found that patients on dupilumab were less likely to experience moderate-to-severe symptoms compared to patients on other systemic treatments (OR=3.89; p=0.008, Table 2A). Furthermore, they were less likely to experience moderate-to-severe symptoms compared to those on limited/no treatments (OR=1.96; p=0.04; Table 2B). Additionally, BMI was significantly associated with moderate-to-severe symptoms across COVID-19 related patients treated with biologic and systemic therapies (p<0.001, Table 2A).
When evaluating the effects of various clinical variables on the presence of COVID-19-related symptoms, we found that non-biologic systemic treatment was significantly associated with symptomatology relative to treatment with dupilumab (OR=1.87; p=0.01, Table 2C). However, there were no differences in predicting symptomatology among patients on dupilumab relative to the limited/no treatment group (Table 2D).