Impact of the COVID-19 pandemic on adults with moderate-to-severe atopic dermatitis in the Dutch general population

Background: The COVID-19 pandemic might disproportionately impact patients with atopic dermatitis (AD). 
Objectives: To investigate associations between COVID-19-related impact and AD severity among adults in the Dutch general population. 
Methods: This cross-sectional study was conducted within the Lifelines Cohort Study. A digital questionnaire was sent out to 135,950 adult participants to collect data on AD in 2020. COVID-19-related variables were collected by regularly sending out questionnaires to 139,735 adult participants between March 2020 and July 2021. Associations between AD severity and COVID-19-related impact were analyzed using binary logistic regression models.
Results: In total, 53,545 subjects, who responded to the AD questionnaire and at least one COVID-19 questionnaire, were included. Multivariate analysis showed similar COVID-19 infection rates in all groups. Subjects with AD, regardless of disease severity, were more concerned about the COVID-19 crisis and more often chose to not contact a doctor when having health problems. Subjects with mild AD had a higher COVID-19 vaccination rate and more frequently covered mouth and nose in public. Moreover, subjects with moderate-to-severe AD estimated a higher chance of becoming infected and expected a more serious disease course. They were more worried about getting sick and a medication shortage, and tended to take other precautions. They also more often expected, reported, and were more afraid of COVID-19 vaccines side effects.