Oral isotretinoin treatment in patients with acne vulgaris during the COVID-19 pandemic: A retrospective cohort study in a tertiary care hospital

Background: Patients with acne vulgaris continue to present increasingly in dermatology outpatient clinics and seek treatment during the COVID-19 pandemic. As far as we know, the effect of isotretinoin on COVID-19 has not been studied before.

Aim: We aimed to evaluate whether patients receiving oral isotretinoin are at increased risk of COVID-19 infection by comparing them with patients on topical treatment for acne vulgaris.

Methods: The data were collected retrospectively from a cohort of 267 acne vulgaris patients, who were under follow-up for acne vulgaris treatment during the pandemic period.

Results: Total of 227 patients (141 receiving isotretinoin treatment and 86 receiving topical treatment) were included of whom 29 patients had COVID-19 infection during acne vulgaris treatment. Fifteen (10.6%) patients were receiving oral isotretinoin and 14 (16.3%) were receiving topical acne treatment at the time of COVID-19 infection. The mean cumulative dose was 2340 ± 1988 mg at the time of COVID-19 infection. The mean elapsed time between the onset of isotretinoin treatment and positive PCR result for COVID-19 was 13.3 ± 10.3 weeks. Nine patients (64.3%) receiving isotretinoin treatment and 9 patients (60%) under topical treatment had loss of taste and smell during COVID-19 infection. Isotretinoin treatment was not found to be associated with a significant increased risk of getting COVID-19 (odds ratio, 0.671; 95% confidence interval, 0.247-1.823; P = 0.434).

Conclusion: As a conclusion, the results of this study encourage dermatologists and acne vulgaris patients to initiate oral isotretinoin treatment safely during the pandemic period.