Problems of Social Hygiene, Public Health and History of MedicineProblems of Social Hygiene, Public Health and History of Medicine0869-866X2412-2106Joint-Stock Company Chicot74810.32687/0869-866X-2021-29-s2-1381-1387Научная статьяBIOLOGICAL TREATMENT OF PSORIASIS IN TIME OF NEW CORONAVIRUS INFECTION COVID-19KruglovaL. S.-PereverzinaN. O.-RudnevaN. S.-KamyninaN. N.-OynotkinovaO. Sh.olga-oynotkinova@yandex.ruCentral State Medical Academy of the Administrative Department of the President of RussiaTula State University, TulaResearch Institute for Healthcare Organization and Medical Management of Moscow Healthcare DepartmentM. V. Lomonosov Moscow State University1512202129S21381138723112021Copyright © 2021,2021Currently, the ongoing pandemic of the novel coronavirus infection is still a major public health problem worldwide. The questions of immunosuppressive therapy of patients with psoriasis and psoriatic arthritis, the possibility of vaccination against the background of the use of genetically engineered drugs remain open. The article is of an overview nature and includes up-to-date information on the feasibility and safety of the use of genetically engineered biological drugs in patients with psoriasis in a pandemic (COVID-19). According to the international recommendations of the National Psoriasis Foundation COVID-19 Task Force expert group, treatment of psoriasis and/or PsA does not significantly alter the risk of SARS-CoV-2 infection and does not lead to worse prognosis of COVID-19. Therefore, patients not infected with SARS-CoV-2 should continue biological or other systemic therapy for psoriasis and/or PsA. According to a registry from 25 countries, hospitalization with SARS-CoV-2 infection was more common in patients receiving nonbiological systemic therapy than in patients receiving BAs. Thus, genetically engineered biological drugs do not appear to cause an increased risk of coronavirus infection and do not determine a more severe course.With regard to vaccination of patients with psoriasis, many issues require further study. According to international agreements, vaccination is not contraindicated in patients with psoriatic disease. However, there is still insufficient data on how the treatment of psoriatic disease affects vaccination. Avoiding COVID-19 or reducing the severity of infection following SARS-CoV-2 vaccination is thought to far outweigh any risk directly related to vaccination complications.COVID-19psoriasispsoriatic arthritisCOVID-19SARS-CoV-2 virusgenetically engineered biological therapyvaccinationпсориазпсориатический артритвирус SARS-CoV-2генно-инженерная биологическая терапиявакцинация[Cascella M., Rajnik M., Cuomo A. et al. Features, evaluation and treatment coronavirus (COVID-19). Florida: StatPearls Publishing, 2020.][Choudhry H., Bakhrebah M. A., Abdulaal W. A., et al. Middle East respiratory syndrome: pathogenesis and therapeutic developments // Future Virol. 2019. Vol. 14. P. 237-246. DOI: 10.2217/fvl-2018-0201.][Круглова Л. С., Хотко А. А., Петрий М. А. Раннее назначение генно-инженерной биологической терапии пациентам с псориазом // Медицинский Алфавит. Дерматология. 2019. Т. 1, № 7. С. 25-28.][Круглова Л. C., Осина А. В., Хотко А. А. Биологическая терапия в лечении псориаза: понятие «выживаемость» препаратов-// Кремлевская медицина. Клинический вестник. 2018. № 3. Р. 191-195.][Conforti C., Giuffrida R., Dianzani C. et al. COVID-19 and psoriasis: is it time to limit treatment with immunosuppressants? A call for action // Dermatol. Ther. 2020. Vol. 333, N 4. P. e13298. DOI: 10.1111/dth.13298.][Круглова Л. С., Шатохина Е. А., Полонская А. С. Вопросы применения генно-инженерных биологических препаратов в условиях пандемии новой коронавирусной инфекции COVID-19. Обзор литературы и описание клинического случая // Российский журнал кожных и венерических болезней. 2020. Т. 23, № 4. С. 218-226. DOI: 10.17816/dv50896.][Diao B., Wang C., Tan Y. et al. Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19) // Front. Immunol. 2020. Vol. 11. P. 827. DOI: 10.3389/fimmu.2020.00827.][Smits S. L., de Lang A., van den Brand J. M. et al. Exacerbated innate host response to SARS-CoV in aged non-human primates // PLoS Pathog. 2010. Vol. 6, N 2. P. e1000756. DOI: 10.1371/journal.ppat.1000756.][Law H. K., Cheung C. Y., Ng H. Y. et al. Chemokine up-regulation in SARS-coronavirus-infected, monocyte-derived human dendritic cells // Blood. 2005. Vol. 106, N 7. P. 2366-2374. DOI: 10.1182/blood-2004-10-4166.][Cheung C. Y., Poon L. L., Ng I. H. et al. Cytokine responses in severe acute respiratory syndrome coronavirus-infected macrophages in vitro: possible relevance to pathogenesis // J. Virol. 2005. Vol. 79, N 12. P. 7819-7826. DOI: 10.1128/JVI.79.12.7819-7826.2005.][Lau S. K. P., Lau C. C. Y., Chan K. H. et al. Delayed induction of proinflammatory cytokines and suppression of innate antiviral response by the novel Middle East respiratory syndrome coronavirus: implications for pathogenesis and treatment // J. General Virol. 2013. Vol. 94, N 12. P. 2679-2690. DOI: 10.1099/vir.0.055533-0.][Channappanavar R., Fehr A. R., Zheng J. et al. IFN-I response timing relative to virus replication determines MERS coronavirus infection outcomes // J. Clin. Invest. 2019. Vol. 129, N 9. P. 3625-3639. DOI: 10.1172/JCI126363.][Perlman S., Netland J. Coronaviruses post-SARS: update on replication and pathogenesis // Nat. Rev. Microbiol. 2009. Vol. 7. P. 439-450. DOI: 10.1038/nrmicro2147.][Mahallawi W. H., Khabour O. F., Zhang Q. et al. MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile // Cytokine. 2018. Vol. 104. P. 8-13. DOI: 10.1016/j.cyto.2018.01.025.][Smith S. B., Dampier W., Tozeren A. et al. Identification of common biological pathways and drug targets across multiple respiratory viruses based on human host gene expression analysis // PLoS ONE. 2012. Vol. 7. P. e33174. DOI: 10.1371/journal.pone.0033174.][Mahallawi W. H., Khabour O. F., Zhang Q. et al. MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile // Cytokine. 2018. Vol. 104. P. 8-13. DOI: 10.1016/j.cyto.2018.01.025.][Channappanavar R., Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopa- thology // Semin. Immunopathol. 2017. Vol. 39. P. 529-539. DOI: 10.1007/s00281-017-0629-x.][Huang C., Wang Y., Li X. et al. Clinical features of patients infected with 2019 novel corona virus in Wuhan, China // Lancet. 2020. Vol. 395, N 10223. P. 497-506. DOI: 10.1016/S0140-6736(20)30183-5.][Mehta P. M., McAuley D. F., Brown M. et al. COVID-19: consider cytokine storm syndromes and immunosuppression // Lancet. 2020. Vol. 395, N 10229. P. 1033-1034. DOI: 10.1016/S0140-6736(20)30628-0.][Takeshita J., Shin D. B., Ogdie A., Gelfand J. M. Risk of serious infection, opportunistic infection, and herpes zoster among patients with psoriasis in the United Kingdom // J. Invest. Dermatol. 2018. Vol. 138. P. 1726-1735. DOI: 10.1016/j.jid.2018.01.039.][Gelfand J. M., Dommasch E. D., Shin D. B. et al. The risk of stroke in patients with psoriasis // J. Invest. Dermatol. 2009. Vol. 129. P. 2411-2418. DOI: 10.1038/jid.2009.112.][Ogdie A., Kay McGill N., Shin D. B. et al. Risk of venous thromboembolism in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a general population-based cohort study // Eur. Heart J. 2018. Vol. 39. P. 3608-3614. DOI: 10.1093/eurheartj/ehx145.][Gisondi P., Piaserico S., Naldi L. et al. Incidence rates of hospitalization and death from COVID-19 in patients with psoriasis receiving biological treatment: a Northern Italy experience // J. Allergy Clin. Immunol. 2021. Vol. 147, N 2. P. 558-560.e1. DOI: 10.1016/j.jaci.2020.10.032.][Montero F., Martínez-Barrio J., Serrano-Benavente B. et al. Coronavirus disease 2019 (COVID-19) in autoimmune and inflammatory conditions: clinical characteristics of poor outcomes // Rheumatol. Int. 2020. Vol. 40, N 10. P. 1593-1598. DOI: 10.1007/s00296-020-04676-4.][Nuno L., Novella Navarro M., Bonilla G. et al. Clinical course, severity and mortality in a cohort of patients with COVID-19 with rheumatic diseases // Ann. Rheum. Dis. 2020. Vol. 79. P. 1659-1661. DOI: 10.1136/annrheumdis-2020-218054.][Akiyama S., Hamdeh S., Micic D., Sakuraba A. Prevalence and clinical outcomes of COVID-19 in patients with autoimmune diseases: a systematic review and meta-analysis // Ann. Rheum. Dis. 2021. Vol. 80. P. 384-391. DOI: http://dx.doi.org/10.1136/annrheumdis-2020-218946.][Alqahtani J. S., Oyelade T., Aldhahir A. M. et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: a rapid systematic review and meta-analysis // PLoS One. 2020. Vol. 15. P. e0233147. DOI: 10.1371/journal.pone.0233147.][Gelfand J. M., Armstrong A. W., Bell S. et al. National psoriasis foundation COVID-19 task force guidance for management of psoriatic disease during the pandemic: version 1 // J. Am. Acad. Dermatol. 2020. Vol. 83, N 6. P. 1704-1716. DOI: 10.1016/j.jaad.2020.09.001.][Mahil S. K., Dand N., Mason K. J. et al. Factors associated with adverse COVID-19 outcomes in patients with psoriasis-insights from a global registry-based study // J. Allergy Clin. Immunol. 2021. Vol. 147, N 1. P. 60-71. DOI: 10.1016/j.jaci.2020.10.007.][Gisondi P., Piaserico S., Naldi L. et al. Incidence rates of hospita ization and death from COVID-19 in patients with psoriasis receiving biological treatment: Northern Italy experience // J. Allergy Clin. Immunol. 2020. Vol. 147, N 2. P. 558-561e1. DOI: 10.1016/j.jaci.2020.10.032.][Talamonti M., Galluzzo M., Chiricozzi A. et al. Characteristic of chronic plaque psoriasis patients treated with biologics in Italy during the COVID-19 pandemic: risk analysis from the PSO-BIO-COVID Observational Study // Expert Opin. Biol. Ther. 2021. Vol. 21, N 2. P. 271-277. DOI: 10.1080/14712598.2021.1853698][Baniandres-Rodrıguez O., Vilar-Alejo J., Rivera R. et al. Incidence of severe COVID-19 outcomes in psoriatic patients treated with systemic therapies during the pandemic: a Biobadaderm cohort analysis // J. Am. Acad. Dermatol. 2021. Vol. 84, N 2. P. 513-517. DOI: 10.1016/j.jaad.2020.10.046][Yousaf A., Gayam S., Feldman S. et al. Clinical outcomes of COVID-19 in patients taking tumor necrosis factor inhibitors or methotrexate: a multicenter research network study // J. Am. Acad. Dermatol. 2021. Vol. 84, N 1. P. 70-75. DOI: 10.1016/j.jaad.2020.09.009.][Michelena X., Borrell H., Lopez-Corbeto M. et al. Incidence of COVID-19 in a cohort of adult and paediatric patients with rheumatic diseases treated with targeted biologic and synthetic disease-modifying anti-rheumatic drugs // Semin. Arthritis Rheum. 2020. Vol. 50, N 4. P. 564-570. DOI: 10.1016/j.semarthrit.2020.05.001.][Cano E. J., Fuentes X. F., Campioli C. C. et al. Impact of corticosteroids in coronavirus disease 2019 outcomes: systematic review and meta-analysis // Chest. 2021. Vol. 159, N 3. P. 1019-1040. DOI: 10.1016/ j.chest.2020.10.054.][Круглова Л. С., Переверзина Н. О., Шатохина Е. А. Вопросы применения генно-инженерных препаратов в условиях новой коронавирусной инфекции COVID-19 // Кремлевская медицина. Клинический вестник. 2020. № 2. С. 36-43. DOI: 10.26269/y5yt-cb97.][Grif ths C. E. M., Armstrong A. W., Gudjonsson J. E., Barker J. Psoriasis // Lancet. 2021. Vol. 397, N 10281. P. 1301-1315. DOI: 10.1016/S0140-6736(20)32549-6.][Amerio P., Prignano F., Giuliani F., Gualdi G. COVID-19 and psoriasis: Should we fear for patients treated with biologics? // Dermatol Ther. 2020. Vol. 33, N 4. P. e13434. DOI: 10.1111/dth.13434.][Damiani G., Allocco F., Young Dermatologists Italian Network, Malagoli P. COVID-19 vaccination and patients with psoriasis under biologics: real-life evidence on safety and effectiveness from Italian vaccinated healthcare workers // Clin. Exp. Dermatol. 2021. Vol. 46, N 6. P. 1106-1108. DOI: 10.1111/ced.14631.][Pacifico A., d'Arino A., Pigatto P. D. M. et al. COVID-19 vaccines do not trigger psoriasis flares in patients with psoriasis treated with apremilast // Clin. Exp. Dermatol. 2021. DOI: 10.1111/ced.14723.][Le H., Vender R. B. A psoriatic patient-based survey on the understanding of the use of vaccines while on biologics during the COVID-19 pandemic // J. Cutan. Med. Surg. 2021. Vol. 25, N 3. P. 298-302. DOI: 10.1177/1203475421991126.][Krajewski P. K., Matusiak Ł., Szepietowski J. C. Psoriasis flare-up associated with second dose of Pfizer-BioNTech BNT16B2b2 COVID-19 mRNA vaccine // J. Eur. Acad. Dermatol. Venereol. 2021. Vol. 35, N 10. P. e632-e634. DOI: 10.1111/jdv.17449.][Onsun N., Kaya G., Işık B. G., Güneş B. A generalized pustular psoriasis flare after CoronaVac COVID-19 vaccination: case report // Health Promot. Perspect. 2021. Vol. 11, N 2. P. 261-262. DOI: 10.34172/hpp.2021.32.][Amerio P., Prignano F., Giuliani F., Gualdi G. COVID-19 and psoriasis: Should we fear for patients treated with biologics? // Dermatol. Ther. 2020. Vol. 33, N 4. P. e13434. DOI: 10.1111/dth.13434.][Megna M., Ruggiero A., Marasca C., Fabbrocini G. Biologics for psoriasis patients in the COVID-19 era: more evidence, less fears // J. Dermatolog. Treat. 2020. Vol. 31, N 4. P. 328-329. DOI: 10.1080/09546634.2020.1757605.][Bardazzi F., Loi C., Sacchelli L., Di Altobrando A. Biologic therapy for psoriasis during the covid-19 outbreak is not a choice // J. Dermatolog. Treat. 2020. Vol. 31, N 4. P. 320-321. DOI: 10.1080/09546634.2020.1749545.][Li G., Fan Y., Lai Y. et al. Coronavirus infections and immune responses // J. Med. Virol. 2020. Vol. 92, N 4. P. 424-432. DOI: 10.1002/jmv.25685.]