Mental health clinicians worldwide have been expressing concerns regarding the broad psychological effects of the COVID-19 pandemic. Nonetheless, only a few studies have thus far evaluated the degree of fear of COVID-19, partially due to the lack of validated measures. In this study we evaluated the psychometric properties of the Hebrew version of the Fear of COVID-19 scale (FCV-19S), recently developed to assess different aspects of the fear of the pandemic, in a normative population of participants in Israel. Participants (n = 639) were asked to complete the FCV-19S scale, as well as to report anxiety, depression, and stress levels using validated scales. The results a unidimensional factor structure of the FCV-19S which explained 53.71% of the variance. When forcing a two-factor structure model, the analysis revealed two factors pertaining to emotional fear reactions and symptomatic expressions of fear. Gender, sociodemographic status, chronic illness, being in an at-risk group, and having a family member dying of COVID-19 were positively associated with fear of COVID-19. The measure was associated with anxiety, stress and depression. These results suggest that the FCV-19S has good psychometric properties, and can be utilized in studies assessing the effects of the pandemic on the population's mental health.

Objective Individuals with schizophrenia may be at an increased risk for COVID-19 morbidity due to the disease characteristics. In this study, we aimed to explore the odds of significant COVID-19 morbidity and mortality among schizophrenia patients while controlling for potential sociodemographic and medical confounders. Methods Schizophrenia patients and age-and-sex matched controls (total n = 51 078) were assessed for frequency of COVID-19 positivity, hospitalizations, and mortality. The odds for COVID-19-associated hospitalization and mortality were calculated using logistic regression models, while controlling for age, sex, marital status, sector, socioeconomic status, diabetes, ischemic heart disease, hypertension, hyperlipidemia, obesity, smoking, and chronic obstructive pulmonary disease. Results Individuals with schizophrenia were less likely to test positive for COVID-19; however, they were twice as likely to be hospitalized for COVID-19 (OR 2.15 95% CI 1.63–2.82, P < .0001), even after controlling for sociodemographic and clinical risk factors (OR 1.88 95% CI 1.39–2.55, P < .0001). Furthermore, they were 3 times more likely to experience COVID-19 mortality (OR 3.27 95% CI 1.39–7.68, P < .0001), compared to controls. Conclusions We found evidence of associations between schizophrenia and increased COVID-19 morbidity and mortality compared to controls regardless of sociodemographic and medical factors. As these patients present with a combination of potential risk factors for mortality, efforts should be made to minimize the effects of the pandemic on this vulnerable population.

Background Individuals with schizophrenia have an increased risk of severe COVID-19 outcomes, nonetheless, no previous study has provided a year-long account of this risk, or assessed postvaccination trends in this population. This study assessed temporal trends in COVID-19 hospitalisation and mortality among people with schizophrenia during the first year of the pandemic, the predictors for COVID-19 vaccination, postvaccination infection, admission to hospital, and mortality.Methods In this longitudinal cohort study, people with schizophrenia (n=25 539) and controls (n=25 539) were assessed for COVID-19 outcomes before and after vaccination, up to April 30, 2021. Cox proportional hazard regression models and Kaplan-Meier analyses were done to assess longitudinal trends. The study used the databases of Clalit Health Services, the largest health-care organisation in Israel.Findings The sample included 51 078 participants, of which 31 141 (61•0%) male and 19 937 (39•0%) female participants, with a mean age of 51•94 years (SD 15•62). Most of the sample was from the general Jewish population (75•9%), followed by the Arab (19•1%) and Jewish Ultraorthodox population (5•1%). Overall of 51 078 individuals, 356 (0•7%) people had been hospitalised, 133 (0•3%) had died, and a total of 27 400 (53•6%) had been vaccinated. People with schizophrenia showed a higher risk for COVID-19 hospitalisation (HR 4•81, 95% CI 3•57-6•48, p<0•0001) and mortality (HR 2•52, 95% CI 1•64-3•85, p<0•0001), and showed a sharper decline in survival as time progressed. The control group showed a sharper incline in probability to vaccinate (log-rank=309•88, p<0•0001). Medical comorbidity of diabetes, hypertension, obesity, or ischaemic heart disease played a significant role in predicting vaccination rates in the schizophrenia group (all p<0•0001), but not in the control group. Hospitalisation and mortality disparities remained higher among people with schizophrenia who had not been vaccinated in comparison to controls (incidence rate difference of 6•2 and 3•2, respectively) but substantially declined in fully vaccinated groups (incidence rate difference of 1•1 and -0•9, respectively).Interpretation People with schizophrenia have higher hospitalisation and mortality risk, yet have lower rates of vaccination than in the general population. Disparities in COVID-19 severe outcomes can be substantially reduced by national vaccination plans aimed at actively reaching out to people with schizophrenia.

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The risk of coronavirus disease (COVID-19) infection and its complications among patients with atopic dermatitis (AD) treated by dupilumab is yet to be determined. We aimed to assess the risk of SARS-CoV-2 infection, COVID-19-associated hospitalization, and mortality among patients with AD treated by dupilumab. A population-based cohort study was conducted to compare AD patients treated by dupilumab (n = 238) with those treated by prolonged systemic corticosteroids (≥ 3 months; n = 1,023), phototherapy (n = 461), and azathioprine or mycophenolate mofetil (MMF; n = 194) regarding the incidence of COVID-19 and its complications. The incidence rate of COVID-19, COVID-19-associated hospitalization, and mortality among patients treated by dupilumab was 70.1 (95% CI, 40.5–116.4), 5.0 (95% CI, 0.3–24.7), and 0.0 per 1,000 person-year, respectively. The use of dupilumab was not associated with an increased risk of SARS-CoV-2 infection [adjusted HR for dupilumab vs. prolonged systemic corticosteroids: 1.13 (95% CI, 0.61–2.09); dupilumab vs. phototherapy: 0.80 (95% CI, 0.42–1.53); dupilumab vs. azathioprine/MMF: 1.10 (95% CI, 0.45–2.65)]. Dupilumab was associated with a comparable risk of COVID-19-associated hospitalization [adjusted HR for dupilumab vs. prolonged systemic corticosteroids: 0.35 (95% CI, 0.05–2.71); dupilumab vs. phototherapy: 0.43 (95% CI, 0.05–3.98); dupilumab vs. azathioprine/MMF: 0.25 (95% CI, 0.02–2.74)]. When applicable, the risk of mortality was not elevated in patients with AD treated by dupilumab [HR for dupilumab vs. prolonged systemic corticosteroids: 0.04 (95% CI, 0.00–225.20)]. To conclude, dupilumab does not impose an increased risk of SARS-CoV-2 infection or COVID-19 complications in patients with AD. Dupilumab should be continued and considered as a safe drug for moderate-to-severe AD during the pandemic.

The risk of coronavirus disease 2019 (COVID‐19) and its complications among patients with psoriasis treated by tumor necrosis factor inhibitors (TNFis) remains to be decisively delineated. We aimed to assess the risk of COVID‐19 infection, COVID‐19‐associated hospitalization, and mortality among Israeli patients with psoriasis treated by TNFi relative to other systemic agents. A population‐based cohort study was conducted to compare psoriasis patients treated by TNFi ( n = 1943), with those treated by methotrexate ( n = 1929), ustekinumab ( n = 348), and acitretin ( n = 1892) regarding COVID‐19 outcomes. Risk of investigated outcomes was assessed using uni‐ and multi‐variate Cox regression analyses. The incidence rate of COVID‐19, COVID‐19‐associated hospitalization, and mortality in the TNFi group was 35.8 (95% CI, 26.1‐47.9), 0.8 (95% CI, 0.0‐4.2), and 0.0 per 1000 person‐years, respectively. Exposure to TNFi was associated with a comparable risk of COVID‐19 infection [adjusted hazard ration (HR) for TNFi vs methotrexate: 1.07 (95% CI, 0.67‐1.71); TNFi vs ustekinumab: 1.07 (95% CI, 0.48‐2.40); TNFi vs acitretin: 0.98 (95% CI, 0.61‐1.57)]. TNFi was associated with a decreased risk of COVID‐19‐associated hospitalization relative to methotrexate (adjusted HR, 0.10; 95% CI, 0.01‐0.82) and ustekinumab (adjusted HR, 0.04; 95% CI, 0.00‐0.64), but not to acitretin (adjusted HR, 1.00; 95% CI, 0.16‐6.16). No significant difference in COVID‐19‐associated mortality was found between the four different groups. TNFi was associated with a decreased risk of admissions due to COVID‐19. Our findings substantiate the continuation of TNFi treatment during the pandemic. TNFi may be positively considered in patients with moderate‐to‐severe psoriasis warranting systemic treatment during the pandemic.

Background The impact of immune-related conditions on the outcomes of coronavirus disease 2019 (COVID-19) is poorly understood. Determinants of COVID-19 outcomes among patients with psoriasis are yet to be established. Objective Th objective of this study was to characterize a large cohort of patients with psoriasis with COVID-19 and to identify predictors of COVID-19-associated hospitalization and mortality. Methods A population-based nested case-control study was performed using the computerized database of Clalit Health Services, Israel. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence (CIs) of predictors for COVID-19-associated hospitalization and mortality. Results The study population included 3151 patients with psoriasis who tested positive for COVID-19. Subclinical COVID-19 infection occurred in 2818 (89.4%) of the patients while 122 (3.9%), 71 (2.3%), 123 (3.9%), and 16 (0.5%) of the patients experienced a mild, moderate, severe, and critical disease, respectively. Overall, 332 (10.5%) patients were hospitalized and 50 (1.6%) patients died because of COVID-19 complications. Intake of methotrexate independently predicted COVID-19-associated hospitalization (adjusted OR 2.30; 95% CI 1.11–4.78; p = 0.025). Use of biologic agents was not associated with COVID-19-associated hospitalization (OR 0.75; 95% CI 0.32–1.73; p = 0.491) or mortality (OR 0.85; 95% CI 0.12–6.21; p = 0.870). Older age, the presence of comorbid cardiovascular diseases, metabolic syndrome, chronic obstructive pulmonary disease, and chronic renal failure independently predicted both COVID-19-associated hospitalization and mortality. Conclusions The use of oral methotrexate was associated with an increased odds of COVID-associated hospitalization, whereas the use of biologic drugs was not associated with worse outcomes of COVID-19 among patients with psoriasis. Supplementary Information The online version contains supplementary material available at 10.1007/s40257-021-00605-8.

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