Atopic dermatitis associated with autoimmune, cardiovascular and mental health comorbidities: a systematic review and meta-analysis

Background: Previous studies have reported conflicting estimates of associations between atopic dermatitis (AD) and autoimmune, cardiovascular and mental health comorbidities. Objectives: Our objective was to determine and report these global associations based on a systematic literature review. Materials & Methods: A systematic search of studies published in PubMed/MEDLINE and Cochrane Library (January 1990–April 2020) including patients with physician-diagnosed AD and concurrent populations, were identified. The metanalysis (random-effect model) included 37 studies. Studies originated from Europe, UK, Asia, The USA and Canada, including 237,226,993 patients and subjects with 20 autoimmune, eight cardiovascular and eight mental illnesses. Results: Pooled analyses revealed significantly higher overall odds of autoimmune diseases (OR: 1.74; 95% CI: 1.55–1.94, p < 0.001; I2:98.39%) and mental illnesses (OR: 1.62; 95% CI: 1.53–1.72; p < 0.001; I2: 98.86%) and a smaller increased risk for cardiovascular diseases (OR: 1.08; 95% CI: 0.01–1.16, p < 0.001; I2: 99.45%). Conclusion: Our systematic review highlights that AD patients are at significantly increased risk for many autoimmune diseases and mental illnesses and at a relatively lower risk for cardiovascular diseases. Updated global estimates should encourage physician/patient empowerment to seek further medical and wellness interventions for optimal patient car