The risk of COVID-19 in patients with bullous pemphigoid and pemphigus: A population-based cohort study

Khalaf Kridin, Yochai Schonmann, Orly Weinstein, Enno Schmidt, Ralf J. Ludwig, Arnon D. Cohen

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: The burden of COVID-19 in patients with bullous pemphigoid (BP) and pemphigus is yet to be evaluated. Objective: To assess the risks of COVID-19 and COVID-19-associated hospitalization and mortality in patients with BP and pemphigus and to delineate determinants of severe COVID-19 illness among these patients. Methods: A population-based cohort study compared COVID-19 and its complications in patients with BP (n = 1845) and pemphigus (n = 1236) with age-, sex-, and ethnicity-matched control subjects. Results: The risks of COVID-19 (hazard rate [HR], 1.12; 95% confidence interval [CI], 0.72-1.73; P =.691) and COVID-19-associated hospitalization (HR, 1.58; 95% CI, 0.84-2.98; P =.160) was comparable between patients with BP and controls. The risk of COVID-19-associated mortality was higher among patients with BP (HR, 2.82; 95% CI, 1.15-6.92; P =.023). The risk of COVID-19 (HR, 0.81; 95% CI, 0.44-1.49; P =.496), COVID-19-associated hospitalization (HR, 1.41; 95% CI, 0.53-3.76; P =.499), and COVID-19-associated mortality (HR, 1.33; 95% CI, 0.15-11.92; P =.789) was similar in patients with pemphigus and their controls. Systemic corticosteroids and immunosuppressants did not predispose COVID-19-positive BP and pemphigus patients to a more severe illness. Limitations: Retrospective data collection. Conclusions: Patients with BP experience increased COVID-19-associated mortality and should be monitored closely. Maintaining systemic corticosteroids and immunosuppressive adjuvant agents during the pandemic is not associated with worse outcomes.

Original languageEnglish
Pages (from-to)79-87
Number of pages9
JournalJournal of the American Academy of Dermatology
Issue number1
StatePublished - Jul 2021

Bibliographical note

Publisher Copyright:
© 2021 American Academy of Dermatology, Inc.


  • COVID-19
  • bullous pemphigoid
  • coronavirus disease 2019
  • hospitalization
  • mortality
  • pemphigus


Dive into the research topics of 'The risk of COVID-19 in patients with bullous pemphigoid and pemphigus: A population-based cohort study'. Together they form a unique fingerprint.

Cite this