THE IMPACT OF THE COVID-19 PANDEMIC ON AUTOIMMUNE BULLOUS DISEASES: A RETROSPECTIVE ANALYSIS

Öz

OBJECTIVE: Autoimmune bullous diseases (AIBDs) are rare but potentially severe conditions characterized by an autoimmune response against structural proteins of the skin and mucosa, leading to significant morbidity and mortality. The COVID-19 (Coronavirus Disease 2019) pandemic represents a major global health crisis that may affect the immune system, potentially triggering or exacerbating autoimmune diseases. This study aims to evaluate the potential impact of COVID-19 on AIBDs by comparing the clinical characteristics, incidence, and treatment responses of patients diagnosed before and after the pandemic. MATERIAL AND METHODS: Patients diagnosed with AIBDs at a university hospital between March 2016 and March 2024 were retrospectively analyzed. Demographic data, disease subtypes, clinical severity, treatment response, and hospitalization requirements were evaluated. RESULTS: A total of 134 patients were included in the study, of whom 62 (46.3%) were diagnosed pre-pandemic and 72 (53.7%) post-pandemic. A significant increase in the incidence of bullous pemphigoid was observed in the post-pandemic period (59.7%, p=0.03). The incidence of AIBDs increased with age (p=0.02). Although no significant difference was found in disease severity, treatment-resistant cases were more frequently observed in the post-pandemic period. CONCLUSIONS: Our study suggests that the COVID-19 pandemic may have contributed to an increased incidence of AIBDs, particularly in elderly individuals, and to the development of treatment resistance.

Anahtar Kelimeler

• Autoimmune bullous diseases
• Pemphigus vulgaris
• Bullous pemphigoid
• COVID-19 pandemic
• Autoimmune diseases.

COVID-19 PANDEMİSİNİN OTOİMMÜN BÜLLÖZ HASTALIKLAR ÜZERİNDEKİ ETKİSİ: RETROSPEKTİF BİR ANALİZ

Öz

AMAÇ: Otoimmün büllöz hastalıklar (OBH) cilt ve mukozanın yapısal proteinlerine karşı otoimmün bir yanıtla karakterize edilen nadir ancak potansiyel olarak ciddi durumlar olup önemli morbidite ve mortaliteye yol açar. COVID-19 (Koronavirüs Hastalığı 2019) pandemisi, bağışıklık sistemini etkileyebilen ve potansiyel olarak otoimmün hastalıkları tetikleyebilen veya kötüleştirebilen büyük bir küresel sağlık krizini temsil etmektedir. Bu çalışmada, pandemi öncesi ve sonrası dönemde OBH tanısı alan hastaların klinik özellikleri, insidansı ve tedavi yanıtları karşılaştırılarak, COVID-19’un OBH üzerindeki olası etkilerinin değerlendirilmesi amaçlanmıştır. GEREÇ VE YÖNTEM: Mart 2016 - Mart 2024 tarihleri arasında bir üniversite hastanesinde OBH tanısı alan hastalar retrospektif olarak incelendi. Demografik veriler, hastalık alt tipleri, klinik şiddet, tedavi yanıtı ve hastaneye yatış gereksinimleri değerlendirildi. BULGULAR: Çalışmaya toplam 134 hasta dahil edildi; bunlardan 62'si (%46,3) pandemi öncesi, 72'si (%53,7) pandemi sonrası teşhis edildi. Pandemi sonrası dönemde büllöz pemfigoid insidansında anlamlı bir artış gözlendi (%59,7, p=0,03). Otoimmün büllöz hastalıkların insidansı yaşla birlikte artış gösterdi. (p=0,02). Hastalığın şiddetinde anlamlı bir fark bulunmamasına rağmen, pandemi sonrası dönemde tedaviye dirençli vakalar daha sık görüldü. SONUÇ: Çalışmamız, COVID-19 pandemisinin özellikle yaşlı bireylerde OBH insidansının artmasına ve tedavi direncinin gelişmesine sebep olabileceğini düşündürmektedir.

Anahtar Kelimeler

• Otoimmün büllöz hastalıklar
• Pemfigus vulgaris
• Büllöz pemfigoid
• COVID-19 pandemisi
• Otoimmün hastalıklar

Kaynakça

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