The Changing Trends in the Incidence and Clinical Presentation of Immunobullous Disorders Before and During the COVID-19 Era in a Tertiary Healthcare Centre in Andhra Pradesh
Abstract
Background Autoimmune immunobullous disorders (AIBDs) represent a heterogeneous group of chronic blistering dermatoses mediated by autoantibodies against desmosomal and hemidesmosomal adhesion molecules. The COVID-19 pandemic has generated significant interest in the interaction between SARS-CoV-2 infection, vaccination-related immune modulation, and the clinical behaviour of autoimmune diseases. Objective This study's primary objective is to compare hospital-based temporal trends in the frequency, subtype distribution, and clinical presentation of AIBDs before and during the COVID-19 era in a tertiary healthcare centre in Andhra Pradesh. Secondary objectives included evaluation of changes in age at onset, sex distribution, mucosal and nail involvement, recurrence, and the emergence of atypical clinical morphologies requiring histopathology and direct immunofluorescence (DIF) for definitive diagnosis, as well as identification of independent predictors of subepidermal AIBD subtypes using multivariate logistic regression. Methods A retrospective observational analysis was performed on 42 histopathology and/or DIF-confirmed AIBD cases. Eighteen cases were recorded in the pre-COVID period (January 2018-December 2019) and 24 during the COVID era (January 2020-November 2023). Demographic trends, morphological patterns, mucosal involvement, anatomical distribution, severity, recurrence, and atypical phenotypes were compared between the two cohorts. Results A notable increase in…
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Evidence Hub reads this as a cohort study. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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