Joly P, Gillibert A, Bohelay G, et al. - Researchers examined the severity and mortality of COVID-19 in patients with autoimmune bullous skin diseases (AIBD), with a special interest in a potential risk factor linked to previous treatment with rituximab.

• This study was conducted in 49 Dermatology Departments located in 12 administrative regions of France.

• Researchers identified 5,180 patients with AIBD, COVID 19 was diagnosed in 59 of these patients; of whom 30 (50.8%) were hospitalized, 7 (11.9%) were admitted to an Intensive Care Unit, and 15 (25.4%) died.

• There were 21 bullous pemphigoid, 19 mucous membrane pemphigoid, 18 pemphigus and 1 pregnant pemphigoid.

• Risk of COVID-19 infection appeared notably higher in AIBD patients treated with rituximab, which corresponded to a more than 5-fold higher incidence of COVID infection than in patients who did not receive rituximab.

• During the first wave of the COVID-19 pandemic, a 5.9-fold higher risk of dying was recorded for patients with AIBD and COVID-19 relative to patients with AIBD and without COVID-19.

• Treatment with rituximab is identified to be a major risk factor of COVID-19 infection.

• Physicians are recommended to carefully evaluate the benefit-risk balance of rituximab therapy during this pandemic period as patients with AIBD are at high risk of death related to COVID-19.