1
|
AlHazmi B, Natto ZS, AlQarni M. Is There a Correlation Between Periodontal Disease Symptoms and the COVID-19 Vaccination? Cureus 2024; 16:e58892. [PMID: 38800223 PMCID: PMC11117175 DOI: 10.7759/cureus.58892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE This study aimed to investigate and compare potential associations between different COVID-19 vaccines and periodontal diseases, mainly gingival bleeding and oral malodor (bad breath). MATERIALS AND METHODS This cross-sectional study used an online questionnaire consisting of 15 questions regarding demographic information, medical history, type of COVID-19 vaccine received, history of COVID-19, and general and periodontal symptoms after vaccination. The survey was voluntary and privately accessed online using SurveyMonkey®. A total of 2000 participants from three regions of Saudi Arabia participated in the study from October 11, 2021, to October 11, 2022. RESULTS Of the participants, 95.8% received at least one dose of the available COVID-19 vaccine. Oxford-AstraZeneca was the most administered (41.7%). Patients who suffered from chronic diseases or had a history of COVID-19 infection were less likely to be vaccinated (OR= 0.62, 95% CI 0.40-0.97; OR=0.62, 95% CI 0.39-0.99) compared with people with no chronic diseases or who had a history of COVID-19. The odds ratios for gingival bleeding, oral malodor, mobility, and tooth loss indicated no significant differences regarding vaccination status. CONCLUSION COVID-19 vaccines might not affect periodontal tissue conditions. People should not avoid vaccination due to concerns with oral or general health, as the benefits of vaccination outweigh the potential side effects.
Collapse
Affiliation(s)
- Bann AlHazmi
- Periodontics and Community Dentistry, King Saud University, Riyadh, SAU
| | - Zuhair S Natto
- Dental Public Health and Periodontology, King Abdulaziz University, Jeddah, SAU
| | - Mayson AlQarni
- Periodontics and Community Dentistry, King Saud University, Riyadh, SAU
| |
Collapse
|
2
|
Verma A, Manojkumar A, Dhasmana A, Tripathi MK, Jaggi M, Chauhan SC, Chauhan DS, Yallapu MM. Recurring SARS-CoV-2 variants: an update on post-pandemic, co-infections and immune response. Nanotheranostics 2024; 8:247-269. [PMID: 38444741 PMCID: PMC10911975 DOI: 10.7150/ntno.91910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/30/2024] [Indexed: 03/07/2024] Open
Abstract
The post-pandemic era following the global spread of the SARS-CoV-2 virus has brought about persistent concerns regarding recurring coinfections. While significant strides in genome mapping, diagnostics, and vaccine development have controlled the pandemic and reduced fatalities, ongoing virus mutations necessitate a deeper exploration of the interplay between SARS-CoV-2 mutations and the host's immune response. Various vaccines, including RNA-based ones like Pfizer and Moderna, viral vector vaccines like Johnson & Johnson and AstraZeneca, and protein subunit vaccines like Novavax, have played critical roles in mitigating the impact of COVID-19. Understanding their strengths and limitations is crucial for tailoring future vaccines to specific variants and individual needs. The intricate relationship between SARS-CoV-2 mutations and the immune response remains a focus of intense research, providing insights into personalized treatment strategies and long-term effects like long-COVID. This article offers an overview of the post-pandemic landscape, highlighting emerging variants, summarizing vaccine platforms, and delving into immunological responses and the phenomenon of long-COVID. By presenting clinical findings, it aims to contribute to the ongoing understanding of COVID-19's progression in the aftermath of the pandemic.
Collapse
Affiliation(s)
- Ashmit Verma
- Divyasampark iHub Roorkee for Devices Materials and Technology Foundation, Indian Institute of Technology Roorkee, Uttarakhand, 247667, India
- Samrat Ashok Technological Institute, Vidisha, Madhya Pradesh, 464001, India
| | - Anjali Manojkumar
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
- Department of Biology, College of Science, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
| | - Anupam Dhasmana
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
- South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
| | - Manish K. Tripathi
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
- South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
| | - Meena Jaggi
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
- South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
| | - Subhash C. Chauhan
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
- South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
| | - Deepak S. Chauhan
- Faculté de Pharmacie, Université de Montréal, Montréal H3C 3J7, QC, Canada
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
- Department of Pediatrics, IWK Research Center, Halifax, NS, Canada
| | - Murali M. Yallapu
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
- South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, Texas 78504, USA
| |
Collapse
|
3
|
Mendoza DJM, Chan DFF, Yu-Keh EN, Sy BCW. Retinal artery occlusion following CoronaVac injection in a 45-year-old Filipino. GMS OPHTHALMOLOGY CASES 2023; 13:Doc12. [PMID: 37575475 PMCID: PMC10413252 DOI: 10.3205/oc000220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Background While complex public health challenges and the emergence of variants have impeded responses to the COVID pandemic, vaccines continue to represent a crucial tool in mitigating the risk of morbidity and mortality. Safety issues weigh heavily upon both the utility and acceptability of every vaccine. Reports of sight-threatening events are scarce. Case description We report the case of a hypertensive 45-year-old Filipino who noted unilateral (right eye) blurring of vision within 48 hours of his first dose of CoronaVac (Sinovac, China), an inactivated SARS-CoV-2/COVID-19 vaccine, with macular retinal arterial occlusion noted on day 21 post-inoculation. Further work-up revealed abnormal glycemic, metabolic, inflammatory, and bleeding parameters. Vision improved from counting fingers to 20/100 at week 6 with no interventions. Conclusion A potential association between retinal vasoocclusion and inoculation with CoronaVac in our patient is supported by the temporal sequence of events, multiple mechanisms put forward in other cases, and reports of vascular adverse reactions in large country-level trials. It is mitigated by the profound infrequency of such events and the potentially substantial risk for ocular ischemic events imparted by the patient's baseline clinical background. Continued understanding of vaccine adverse reactions, however rare, is important not only for individual patient safety. This is helpful in ensuring the utility of current vaccines and in preserving the acceptability of vaccines through and beyond the current pandemic.
Collapse
Affiliation(s)
| | - David Francis F. Chan
- Department of Ophthalmology, Veterans Memorial Medical Center, Quezon City, Philippines
| | - Ellen N. Yu-Keh
- Department of Ophthalmology, Veterans Memorial Medical Center, Quezon City, Philippines
- Eye Institute, St. Lukes Medical Center, Quezon City, Philippines
| | | |
Collapse
|
4
|
Kianfar N, Dasdar S, Daneshpazhooh M, Aryanian Z, Goodarzi A. A systematic review on efficacy, safety and treatment durability of intravenous immunoglobulin in autoimmune bullous dermatoses: Special focus on indication and combination therapy. Exp Dermatol 2023. [PMID: 37150538 DOI: 10.1111/exd.14829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/10/2023] [Accepted: 04/23/2023] [Indexed: 05/09/2023]
Abstract
Autoimmune bullous diseases (AIBDs) are a group of rare blistering dermatoses of the mucous membrane and/or skin. The efficacy, safety and treatment durability of intravenous immunoglobulin (IVIg) as an alternative treatment should be explored to systematically review the available literature regarding treatment outcomes with IVIg in AIBD patients. The predefined search strategy was incorporated into the following database, MEDLINE/PubMed, Embase, Scopus and Web of Science on 18 July 2022. Sixty studies were enrolled using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The use of IVIg alone or combined with rituximab was reported in 500 patients with pemphigus, 82 patients with bullous pemphigoid, 146 patients with mucous membranes pemphigoid and 19 patients with epidermolysis bullosa acquisita. Disease remission with IVIg therapy and RTX + IVIg combination therapy were recorded as 82.8% and 86.7% in pemphigus, 88.0% and 100% in bullous pemphigoid and 91.3% and 75.0% in mucous membrane pemphigoid, respectively. In epidermolysis bullosa acquisita, treatment with IVIg led to 78.6% disease remission; no data were available regarding the treatment with RTX + IVIg in this group of patients. Among all the included patients, 37.5% experienced at least one IVIg-related side effect; the most common ones were headaches, fever/chills and nausea/vomiting. The use of IVIg with or without rituximab had a favourable clinical response in patients with AIBDs. IVIg has no major influence on the normal immune system, which makes its utilization for patients with AIBDs reasonable.
Collapse
Affiliation(s)
- Nika Kianfar
- Department of Dermatology, Razi Dermatology Hospital, Autoimmune Bullous Diseases Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Dasdar
- Department of Dermatology, Razi Dermatology Hospital, Autoimmune Bullous Diseases Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Department of Dermatology, Razi Dermatology Hospital, Autoimmune Bullous Diseases Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Aryanian
- Department of Dermatology, Razi Dermatology Hospital, Autoimmune Bullous Diseases Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Soeiro EMD, Penido MGMG, Palma LMP, Bresolin NL, Lima EJDF, Koch VHK, Tavares MDS, Sylvestre L, Bernardes RDP, Garcia CD, de Andrade MC, Kaufman A, Chow CYZ, Martins SBS, Camargo SFDN. The challenges of the pandemic and the vaccination against covid-19 in pediatric patients with kidney disease. J Bras Nefrol 2023; 45:244-251. [PMID: 36282106 PMCID: PMC10627141 DOI: 10.1590/2175-8239-jbn-2022-0081en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 09/11/2022] [Indexed: 11/21/2022] Open
Abstract
The covid-19 vaccine confers direct protection and reduces transmission rates of the virus and new variants. Vaccines from Pfizer/BioNTech and CoronaVac have been cleared for children in Brazil. They are safe, effective, and immunogenic. There are no known complications associated with the use of steroids or vaccines in pediatric patients with covid-19 and nephrotic syndrome. With or without immunosuppression, these patients are not at increased risk of severe covid-19, and steroids are safe for them. A milder form of covid-19 occurs in patients with chronic kidney disease without the need for hospitalization. The vaccine response may be reduced and/or the duration of antibodies after vaccination may be shorter than in the general population. However, considering risk of exposure, vaccination against covid-19 is recommended. It is believed that patients with hemolytic-uremic syndrome are at higher risk of severe covid-19. Vaccination is recommended, although specific data on the safety and efficacy of the covid-19 vaccine are limited. There is agreement that the benefits of induced immunity outweigh the risks of immunization. Vaccination against covid-19 is recommended for children and adolescents needing kidney transplantation or who have undergone transplantation. These patients present decreased immune response after vaccination, but immunization is recommended because the benefits outweigh the risks of vaccination. Current recommendations in Brazil stipulate the use of the messenger RNA vaccine. This paper aims to provide pediatric nephrologists with the latest knowledge about vaccination against covid-19 for children with kidney disease.
Collapse
Affiliation(s)
| | | | | | | | | | - Vera Hermina Kalika Koch
- Hospital das Clínicas da Faculdade de Medicina da USP, Instituto da
Criança e do Adolescente, São Paulo, SP, Brazil
| | - Marcelo de Sousa Tavares
- Santa Casa de Belo Horizonte, Centro de Nefrologia, Unidade de
Nefrologia Pediátrica, Belo Horizonte, MG, Brazil
| | | | | | - Clotilde Druck Garcia
- Universidade Federal de Ciências da Saúde de Porto Alegre, Santa
Casa de Porto Alegre, Serviço de Pediátrica, Porto Alegre, RS, Brazil
| | | | - Arnauld Kaufman
- Instituto de Puericultura e Pediatria Martagão Gesteira, Rio de
Janeiro, RJ, Brazil
- Universidade Federal do Rio de Janeiro, RJ, Brazil
- Hospital Federal dos Servidores do Estado do Rio de Janeiro, RJ,
Brazil
- Grupo Assistência Médica Nefrológica, Rio de Janeiro, RJ,
Brazil
| | | | | | | |
Collapse
|
6
|
Erdes SF, Belov BS. Axial spondyloarthritis and COVID-19: course, interactions, outcomes, and the role of vaccination. MODERN RHEUMATOLOGY JOURNAL 2023. [DOI: 10.14412/1996-7012-2023-1-101-107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The review analyzes data on the course and outcomes of axial spondyloarthritis (axSpA) accumulated over the previous 2.5 years of the COVID-19 pandemic. The issues of clinical and immunological efficacy of vaccination against COVID-19 in this disease are considered. It was noted that the presence of axSpA, as well as treatment with tumor necrosis factor-á inhibitors and non-steroidal anti-inflammatory drugs, did not significantly increase the risk of COVID-19 infection and did not worsen its outcomes, apart from an increase in the incidence of venous thromboembolism. At the same time, it is assumed that anticytokine therapy for SpA may protect against severe COVID-19 course.The data presented suggest that the benefits of vaccination in SpA far outweigh the potential harms associated with the development of adverse events. It has been shown that in patients with SpA, vaccination does not affect the activity of the inflammatory process, and biologic disease modifying antirheumatic drugs have almost no significant effect on the post-vaccination response.
Collapse
Affiliation(s)
- Sh. F. Erdes
- V.A. Nasonova Research Institute of Rheumatology
| | - B. S. Belov
- V.A. Nasonova Research Institute of Rheumatology
| |
Collapse
|
7
|
Chanprapaph K, Seree-Aphinan C, Rattanakaemakorn P, Pomsoong C, Ratanapokasatit Y, Setthaudom C, Thitithanyanont A, Suriyo A, Suangtamai T, Suchonwanit P. A real-world prospective cohort study of immunogenicity and reactogenicity of ChAdOx1-S[recombinant] among patients with immune-mediated dermatological diseases. Br J Dermatol 2023; 188:268-277. [PMID: 36637102 DOI: 10.1093/bjd/ljac045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/17/2022] [Accepted: 09/30/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Immunogenicity and reactogenicity of COVID-19 vaccines have been established in various groups of immunosuppressed patients; however, studies involving patients with immune-mediated dermatological diseases (IMDDs) are scarce. OBJECTIVES To investigate the influence of IMDDs on the development of SARS-CoV-2-specific immunity and side-effects following ChAdOx1-S[recombinant] vaccination. METHODS This prospective cohort study included 127 patients with IMDDs and 97 participants without immune-mediated diseases who received ChAdOx1-S[recombinant]. SARS-CoV-2-specific immunity and side-effect profiles were assessed at 1 month postvaccination and compared between groups. Immunological (primary) outcomes were the percentages of participants who tested positive for neutralizing antibodies [seroconversion rate (SR)] and those who developed T-cell-mediated immunity demonstrated by an interferon-γ-releasing assay (IGRA) [positive IGRA rate (+IGRA)]. Reactogenicity-related (secondary) outcomes were the unsolicited adverse reactions and worsening of IMDD activity reflected by the uptitration of immunosuppressants during and within 1 month of vaccination. RESULTS Overall, the SR for the IMDD group was similar to that of participants without immune-mediated conditions (75·6 vs. 84·5, P = 0·101), whereas + IGRA was lower (72·4 vs. 88·7, P = 0·003). Reactogenicity was similar between groups. No severe adverse reaction was reported. By stratifying the participants in the IMDD group according to individual disease, the immunogenicity of the vaccine was lowest in patients with autoimmune bullous diseases (AIBD) (SR 64·5%, +IGRA 62·9%) and highest in patients with psoriasis (SR 87·7%, +IGRA 80·7%). The reverse trend was found for vaccine-related reactions. Immunosuppressants were uptitrated in 15·8% of cases; 75% of these were patients with AIBD. CONCLUSIONS Among participants with IMDDs, ChAdOx1-S[recombinant] showed good immunogenicity among patients with psoriasis, but demonstrated lower levels of immunogenicity for patients with AIBD. Some patients, especially patients with AIBD, should be closely monitored as they may require treatment escalation within 1 month postvaccination.
Collapse
Affiliation(s)
| | | | | | - Cherrin Pomsoong
- Division of Dermatology, Department of Medicine, Faculty of Medicine
| | | | | | | | | | - Thanitta Suangtamai
- Division of Allergy, Immunology, and Rheumatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand
| | - P Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine
| | | |
Collapse
|
8
|
Sen P, R N, Nune A, Lilleker JB, Agarwal V, Kardes S, Kim M, Day J, Milchert M, Gheita T, Salim B, Velikova T, Gracia-Ramos AE, Parodis I, O’Callaghan AS, Nikiphorou E, Chatterjee T, Tan AL, Cavagna L, Saavedra MA, Shinjo SK, Ziade N, Knitza J, Kuwana M, Distler O, Chinoy H, Agarwal V, Aggarwal R, Gupta L. COVID-19 vaccination-related adverse events among autoimmune disease patients: results from the COVAD study. Rheumatology (Oxford) 2022; 62:65-76. [PMID: 35713499 PMCID: PMC9214139 DOI: 10.1093/rheumatology/keac305] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/14/2022] [Accepted: 05/09/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES COVID-19 vaccines have been proven to be safe in the healthy population. However, gaps remain in the evidence of their safety in patients with systemic autoimmune and inflammatory disorders (SAIDs). COVID-19 vaccination-related adverse events (AEs) in patients with SAIDs and healthy controls (HC) seven days post-vaccination were assessed in the COVAD study, a patient self-reported cross-sectional survey. METHODS The survey was circulated in early 2021 by >110 collaborators (94 countries) to collect SAID details, COVID-19 vaccination details and 7-day vaccine AEs, irrespective of respondent vaccination status. Analysis was performed based on data distribution and variable type. RESULTS Ten thousand nine hundred respondents [median (interquartile range) age 42 (30-55) years, 74% females and 45% Caucasians] were analysed; 5867 patients (54%) with SAIDs were compared with 5033 HCs. Seventy-nine percent had minor and only 3% had major vaccine AEs requiring urgent medical attention (but not hospital admission) overall. Headache [SAIDs = 26%, HCs = 24%; odds ratio (OR) = 1.1 (95% CI: 1.03, 1.3); P = 0.014], abdominal pain [SAIDs = 2.6%, HCs = 1.4%; OR = 1.5 (95% CI: 1.1, 2.3); P = 0.011], and dizziness [SAIDs = 6%, HCs = 4%; OR = 1.3 (95% CI: 1.07, 1.6); P = 0.011], were slightly more frequent in SAIDs. Overall, major AEs [SAIDs = 4%, HCs = 2%; OR = 1.9 (95% CI: 1.6, 2.2); P < 0.001] and, specifically, throat closure [SAIDs = 0.5%, HCs = 0.3%; OR = 5.7 (95% CI: 2.9, 11); P = 0.010] were more frequent in SAIDs though absolute risk was small (0-4%). Major AEs and hospitalizations (<2%) were comparable across vaccine types in SAIDs. CONCLUSION Vaccination against COVID-19 is safe in SAID patients. SAIDs were at a higher risk of major AEs than HCs, though absolute risk was small. There are small differences in minor AEs between vaccine types in SAID patients.
Collapse
Affiliation(s)
| | - Naveen R
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - James B Lilleker
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre,The University of Manchester, Manchester, UK
- Neurology Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Vishwesh Agarwal
- Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India
| | - Sinan Kardes
- Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey
| | - Minchul Kim
- Center for Outcomes Research, Department of Internal Medicine, University of Illinois College of Medicine Peoria, Illinois, USA
| | - Jessica Day
- Department of Rheumatology, Royal Melbourne Hospital, Parkville, VIC 3050, Australia
- Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052 Australia
- Department of Medical Biology, University of Melbourne, Parkville, VIC 3052 Australia
| | - Marcin Milchert
- Department of Internal Medicine, Rheumatology, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, ul Unii Lubelskiej 1, 71-252, Szczecin, Poland
| | - Tamer Gheita
- Rheumatology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Babur Salim
- Rheumatology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan
| | - Tsvetelina Velikova
- Department of Clinical Immunology, Medical Faculty, University Hospital "Lozenetz", Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407, Sofia, Bulgaria
| | - Abraham Edgar Gracia-Ramos
- Department of Internal Medicine, General Hospital, National Medical Center “La Raza”, Instituto Mexicano del Seguro Social, Av. Jacaranda S/N, Col. La Raza, Del. Azcapotzalco, C.P. 02990 Mexico City, Mexico
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Albert Selva O’Callaghan
- Internal Medicine Department, Vall D'hebron General Hospital, Universitat Autonoma de Barcelona, 08035 Barcelona, Spain
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King’s College London, London, UK
- Rheumatology Department, King's College Hospital, London, UK
| | - Tulika Chatterjee
- Center for Outcomes Research, Department of Internal Medicine, University of Illinois College of Medicine Peoria, Illinois, USA
| | - Ai Lyn Tan
- NIHR Leeds Biomedical Research Centre,Leeds Teaching Hospitals Trust, Leeds, UK
- Leeds Institute of Rheumatic and Musculoskeletal Medicine,University of Leeds, Leeds, UK
| | - Lorenzo Cavagna
- Rheumatology Unit, Dipartimento di Medicine Interna e Terapia Medica, Università degli studi di Pavia, Pavia, Lombardy, Italy
| | - Miguel A Saavedra
- Departamento de Reumatología Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, IMSS, Mexico City, Mexico
| | - Samuel Katsuyuki Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Nelly Ziade
- Rheumatology Department, Saint-Joseph University, Beirut, Lebanon
- Rheumatology Department, Hotel-Dieu de France Hospital, Beirut, Lebanon
| | - Johannes Knitza
- Medizinische Klinik 3 - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland
| | - Masataka Kuwana
- Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
| | - Oliver Distler
- Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hector Chinoy
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre,The University of Manchester, Manchester, UK
- National Institute for Health Research Manchester Biomedical Research Centre,Manchester University NHS Foundation Trust,The University of Manchester, Manchester, UK
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Latika Gupta
- Correspondence to: Dr. Latika Gupta. Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, WV10 0QP, United Kingdom. - , +4401902 307999
| | | |
Collapse
|
9
|
Peshevska-Sekulovska M, Bakalova P, Snegarova V, Lazova S, Velikova T. COVID-19 Vaccines for Adults and Children with Autoimmune Gut or Liver Disease. Vaccines (Basel) 2022; 10:vaccines10122075. [PMID: 36560485 PMCID: PMC9781431 DOI: 10.3390/vaccines10122075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/07/2022] Open
Abstract
The SARS-CoV-2 pandemic raised many challenges for all patients with chronic conditions and those with autoimmune diseases, both adults and children. Special attention is paid to their immunological status, concomitant diseases, and the need for immunosuppressive therapy. All of these factors may impact their COVID-19 course and outcome. COVID-19 vaccination is accepted as one of the most successful strategies for pandemic control. However, individuals with immune-mediated chronic diseases, including autoimmune liver and gut diseases, have been excluded from the vaccine clinical trials. Therefore, we rely on real-world data from vaccination after vaccine approval for these patients to fill the evidence gap for the long-term safety and efficacy of COVID-19 vaccines in patients with autoimmune gut and liver diseases. Current recommendations from inflammatory bowel disease (IBD) societies suggest COVID-19 vaccination in children older than 5 years old, adults and even pregnant females with IBD. The same recommendations are applied to patients with autoimmune liver diseases. Nevertheless, autoimmune disease patients still experience high levels of COVID-19 vaccine hesitancy, and more studies have to be conducted to clarify this issue.
Collapse
Affiliation(s)
- Monika Peshevska-Sekulovska
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, 1407 Sofia, Bulgaria
| | - Plamena Bakalova
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
| | - Violeta Snegarova
- Clinic of Internal Diseases, Naval Hospital—Varna, Military Medical Academy, Medical Faculty, Medical University, 9000 Varna, Bulgaria
| | - Snezhina Lazova
- Pediatric Department, University Hospital “N. I. Pirogov”,“General Eduard I. Totleben” Blvd 21, Health Care Department, 1606 Sofia, Bulgaria
- Faculty of Public Health, Medical University Sofia, Bialo More 8 Str., 1527 Sofia, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University St. Kliment Ohridski, 1407 Sofia, Bulgaria
- Department of Clinical Immunology, University Hospital Lozenetz, Medical Faculty, Sofia University St. Kliment Ohridski, 1407 Sofia, Bulgaria
- Correspondence:
| |
Collapse
|
10
|
Soeiro EMD, Penido MGMG, Palma LMP, Bresolin NL, Lima EJDF, Koch VHK, Tavares MDS, Sylvestre L, Bernardes RDP, Garcia CD, Andrade MCD, Kaufman A, Chow CYZ, Martins SBS, Camargo SFDN. Os desafios da pandemia e a vacinação covid-19 na população pediátrica com doenças renais. J Bras Nefrol 2022. [DOI: 10.1590/2175-8239-jbn-2022-0081pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo A vacina covid-19 confere proteção direta, reduz as taxas de transmissão do vírus e de novas variantes. No Brasil, estão liberadas para a população pediátrica as vacinas Pfizer/BioNTech e a CoronaVac, ambas seguras, eficazes e imunogênicas. Pacientes pediátricos com síndrome nefrótica e covid-19 têm curso clínico regular sem complicações relacionadas ao uso de esteroides ou vacinas. Esses pacientes, com ou sem imunossupressão, não apresentam maior risco de covid-19 grave e o tratamento com esteroides é seguro. Os pacientes com doença renal crônica têm covid-19 mais leve, sem necessidade de hospitalização. A resposta vacinal pode ser reduzida e/ou a duração dos anticorpos pós-vacinação pode ser menor do que na população geral. Entretanto, a vacina covid-19 está recomendada, considerando o risco de exposição. Acredita-se que pacientes com síndrome hemolítico-urêmica teriam maior risco de covid-19 grave. A vacina é recomendada, embora dados específicos sobre segurança e eficácia da vacina covid-19 sejam limitados. Há concordância que os benefícios da imunidade induzida superam quaisquer riscos da imunização. A vacina covid-19 é recomendada para crianças e adolescentes candidatos ao transplante renal ou já transplantados. Esses pacientes têm resposta imunológica reduzida após a vacina, entretanto ela é recomendada porque os benefícios superam qualquer risco dessa vacinação. A recomendação atual no Brasil é a vacina de tecnologia RNA mensageiro. O objetivo deste documento é levar aos nefrologistas pediátricos os conhecimentos mais recentes sobre a vacinação contra contra-19 em crianças com doenças renais.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Arnauld Kaufman
- Instituto de Puericultura e Pediatria Martagão Gesteira, Brazil; Universidade Federal do Rio de Janeiro, Brazil; Hospital Federal dos Servidores do Estado do Rio de Janeiro, Brazil; Grupo Assistência Médica Nefrológica, Brazil
| | | | | | | |
Collapse
|
11
|
Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 154] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
Collapse
Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
| |
Collapse
|
12
|
Cannatelli R, Ferretti F, Carmagnola S, Bergna IMB, Monico MC, Maconi G, Ardizzone S. Risk of adverse events and reported clinical relapse after COVID-19 vaccination in patients with IBD. Gut 2022; 71:1926-1928. [PMID: 34819330 DOI: 10.1136/gutjnl-2021-326237] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/16/2021] [Indexed: 02/06/2023]
Affiliation(s)
- Rosanna Cannatelli
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Francesca Ferretti
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Stefania Carmagnola
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Irene Maria Bambina Bergna
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Maria Camilla Monico
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Giovanni Maconi
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Sandro Ardizzone
- Gastroenterology and Digestive Endoscopy Unit, Department of Biochemical and Clinical Sciences 'L Sacco', University of Milan, ASST Fatebenefratelli Sacco, Milano, Italy
| |
Collapse
|
13
|
Udaondo C, Cámara C, Miguel Berenguel L, Alcobendas Rueda R, Muñoz Gómez C, Millán Longo C, Díaz-Delgado B, Falces-Romero I, Díaz Almirón M, Ochando J, Méndez-Echevarría A, Remesal Camba A, Calvo C. Humoral and cellular immune response to mRNA SARS-CoV-2 BNT162b2 vaccine in adolescents with rheumatic diseases. Pediatr Rheumatol Online J 2022; 20:64. [PMID: 35964130 PMCID: PMC9375068 DOI: 10.1186/s12969-022-00724-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Data about safety and efficacy of the mRNA SARS-CoV-2 vaccine in adolescents with rheumatic diseases (RD) is scarce and whether these patients generate a sufficient immune response to the vaccine remains an outstanding question. OBJECTIVE To evaluate safety and humoral and cellular immunity of the BNT162b2 vaccine in adolescents 12 to 18 years with RD and immunosuppressive treatment compared with a healthy control group. METHODS Adolescents from 12 to 18 years with RD followed at Hospital La Paz in Madrid (n = 40) receiving the BNT162b2 mRNA vaccination were assessed 3 weeks after complete vaccination. Healthy adolescents served as controls (n = 24). Humoral response was measured by IgG antiSpike antibodies, and cellular response by the quantity of IFN-γ and IL-2 present in whole blood stimulated with SARS-CoV-2 Spike and M proteins. RESULTS There were no differences in spike-specific humoral or cellular response between groups (median IFN-γ response to S specific protein; 528.80 pg/ml in controls vs. 398.44 in RD patients, p 0.78, and median IL-2 response in controls: 635.68 pg/ml vs. 497.30 in RD patients, p 0.22. The most frequent diagnosis was juvenile idiopathic arthritis (26/40, 65%) followed by Lupus (6/40, 15%). 60% of cases (23/40) received TNF inhibitors and 35% (14/40) methotrexate. 40% of patients (26/64) had previous SARS-CoV-2 infection, 9 in the control group and 17 in the RD patients without differences. Of note, 70% of infections were asymptomatic. A higher IFN-γ production was found in COVID-19 recovered individuals than in naive subjects in both groups (controls: median 859 pg/ml in recovered patients vs. 450 in naïve p 0.017, and RD patients: 850 in recovered vs. 278 in naïve p 0.024). No serious adverse events or flares were reported following vaccination. CONCLUSIONS We conclude that standard of care treatment for adolescents with RD including TNF inhibitors and methotrexate did not affect the humoral and the cellular immunity to BNT162b2 mRNA vaccination compared to a healthy control group. The previous contact with SARS-CoV-2 was the most relevant factor in the immune response.
Collapse
Affiliation(s)
- Clara Udaondo
- Paediatric Rheumatology Unit, Hospital Infantil La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.
- La Paz Institute of Biomedical Research (IdiPAZ), 28046, Madrid, Spain.
- CIBERINFEC, Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
| | - Carmen Cámara
- La Paz Institute of Biomedical Research (IdiPAZ), 28046, Madrid, Spain
- Department of Immunology, Hospital La Paz, 28046, Madrid, Spain
| | | | - Rosa Alcobendas Rueda
- Paediatric Rheumatology Unit, Hospital Infantil La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Celia Muñoz Gómez
- Paediatric Rheumatology Unit, Hospital Infantil La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Claudia Millán Longo
- Paediatric Rheumatology Unit, Hospital Infantil La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Blanca Díaz-Delgado
- Paediatric Rheumatology Unit, Hospital Infantil La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Iker Falces-Romero
- La Paz Institute of Biomedical Research (IdiPAZ), 28046, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Microbiology and Parasitology Department, Hospital La Paz, 28046, Madrid, Spain
| | - Mariana Díaz Almirón
- La Paz Institute of Biomedical Research (IdiPAZ), 28046, Madrid, Spain
- Biostatistics, Hospital La Paz, 28046, Madrid, Spain
| | - Jordi Ochando
- National Microbiology Centre, Instituto de Salud Carlos III, 28220, Madrid, Spain
| | - Ana Méndez-Echevarría
- La Paz Institute of Biomedical Research (IdiPAZ), 28046, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Paediatric and Infectious Diseases Department, Hospital La Paz, 28046, Madrid, Spain
- Paediatric Translational Network in Infectious Diseases (RITIP), Madrid, Spain
| | - Agustín Remesal Camba
- Paediatric Rheumatology Unit, Hospital Infantil La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Cristina Calvo
- La Paz Institute of Biomedical Research (IdiPAZ), 28046, Madrid, Spain
- CIBERINFEC, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Paediatric and Infectious Diseases Department, Hospital La Paz, 28046, Madrid, Spain
- Paediatric Translational Network in Infectious Diseases (RITIP), Madrid, Spain
| |
Collapse
|
14
|
Cebeci Kahraman F, Savaş Erdoğan S, Aktaş ND, Albayrak H, Türkmen D, Borlu M, Arıca DA, Demirbaş A, Akbayrak A, Polat Ekinci A, Gökçek GE, Çelik HA, Taşolar MK, An İ, Temiz SA, Hazinedar E, Ayhan E, Hızlı P, Solak EÖ, Kılıç A, Yılmaz E. Cutaneous reactions after COVID-19 vaccination in Turkey: A multicenter study. J Cosmet Dermatol 2022; 21:3692-3703. [PMID: 35780311 PMCID: PMC9349975 DOI: 10.1111/jocd.15209] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/21/2022] [Accepted: 06/30/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES In this study covering all of Turkey, we aimed to define cutaneous and systemic adverse reactions in our patient population after COVID-19 vaccination with the Sinovac/CoronaVac (inactivated SARS-CoV-2) and Pfizer/BioNTech (BNT162b2) vaccines. METHODS This prospective, cross-sectional study included individuals presenting to the dermatology or emergency outpatient clinics of a total of 19 centers after having been vaccinated with the COVID-19 vaccines. Systemic, local injection site, and non-local cutaneous reactions after vaccination were identified, and their rates were determined. RESULTS Of the 2290 individuals vaccinated between April 15 and July 15, 2021, 2097 (91.6%) received the CoronaVac vaccine and 183 (8%) BioNTech. Systemic reactions were observed at a rate of 31.0% after the first CoronaVac dose, 31.1% after the second CoronaVac dose, 46.4% after the first BioNTech dose, and 46.2% after the second BioNTech dose. Local injection site reactions were detected at a rate of 35.6% after the first CoronaVac dose, 35.7% after the second CoronaVac dose, 86.9% after the first BioNTech dose, and 94.1% after the second BioNTech dose. A total of 133 non-local cutaneous reactions were identified after the CoronaVac vaccine (2.9% after the first dose and 3.5% after the second dose), with the most common being urticaria/angioedema, pityriasis rosea, herpes zoster, and maculopapular rash. After BioNTech, 39 non-local cutaneous reactions were observed to have developed (24.8% after the first dose and 5% after the second dose), and the most common were herpes zoster, delayed large local reaction, pityriasis rosea, and urticaria/angioedema in order of frequency. Existing autoimmune diseases were triggered in 2.1% of the patients vaccinated with CoronaVac and 8.2% of those vaccinated with BioNTech. CONCLUSIONS There are no comprehensive data on cutaneous adverse reactions specific to the CoronaVac vaccine. We determined the frequency of adverse reactions from the dermatologist's point of view after CoronaVac and BioNTech vaccination and identified a wide spectrum of non-local cutaneous reactions. Our data show that CoronaVac is associated with less harmful reactions while BioNTech may result in more serious reactions, such as herpes zoster, anaphylaxis, and triggering of autoimmunity. However, most of these reactions were self-limiting or required little therapeutic intervention.
Collapse
Affiliation(s)
- Filiz Cebeci Kahraman
- Department of Dermatologyİstanbul Medeniyet University, Göztepe Prof. Dr. Süleyman Yalçın City HospitalİstanbulTurkey
| | - Sevil Savaş Erdoğan
- Department of DermatologyUniversity of Health Sciences, İstanbul Training and Research HospitalİstanbulTurkey
| | - Nurhan Döner Aktaş
- Department of Dermatologyİzmir Katip Çelebi University, Atatürk Training and Research HospitalİzmirTurkey
| | - Hülya Albayrak
- Department of Dermatology, Faculty of MedicineNamık Kemal UniversityTekirdağTurkey
| | - Dursun Türkmen
- Department of Dermatology, Faculty of Medicineİnönü UniversityMalatyaTurkey
| | - Murat Borlu
- Department of Dermatology, Faculty of MedicineErciyes UniversityKayseriTurkey
| | - Deniz Aksu Arıca
- Department of Dermatology, Faculty of MedicineKaradeniz Technical UniversityTrabzonTurkey
| | - Abdullah Demirbaş
- Department of Dermatology, Faculty of MedicineKocaeli UniversityKocaeliTurkey
| | - Atiye Akbayrak
- Department of Dermatology, Faculty of MedicineGaziosmanpaşa UniversityTokatTurkey
| | - Algün Polat Ekinci
- Department of Dermatology, İstanbul Faculty of Medicineİstanbul UniversityİstanbulTurkey
| | - Gözde Emel Gökçek
- Department of Dermatology, Faculty of MedicineYozgat Bozok UniversityYozgatTurkey
| | - Hilal Ayvaz Çelik
- Department of Dermatology, Faculty of MedicineIsparta Süleyman Demirel UniversityIspartaTurkey
| | | | - İsa An
- Department of DermatologyŞanlıurfa Training and Research HospitalŞanlıurfaTurkey
| | - Selami Aykut Temiz
- Department of DermatologyNecmettin Erbakan University Meram Faculty of MedicineKonyaTurkey
| | - Emel Hazinedar
- Department of Dermatology, Faculty of MedicineZonguldak Bülent Ecevit UniversityZonguldakTurkey
| | - Erhan Ayhan
- Department of DermatologyUniversity of Health Sciences, Gazi Yaşargil Training and Research HospitalDiyarbakırTurkey
| | - Pelin Hızlı
- Department of Dermatology, Faculty of MedicineBalıkesir UniversityBalıkesirTurkey
| | - Eda Öksüm Solak
- Department of Dermatology, Faculty of MedicineErciyes UniversityKayseriTurkey
| | - Arzu Kılıç
- Department of Dermatology, Faculty of MedicineBalıkesir UniversityBalıkesirTurkey
| | - Ertan Yılmaz
- Department of Dermatology, Faculty of MedicineAkdeniz UniversityAntayaTurkey
| |
Collapse
|
15
|
Paybast S, Emami A, Baghalha F, Naser Moghadasi A. Watch out for neuromyelitis optica spectrum disorder onset or clinical relapse after COVID-19 vaccination: What neurologists need to know? Mult Scler Relat Disord 2022; 65:103960. [PMID: 35763914 PMCID: PMC9186785 DOI: 10.1016/j.msard.2022.103960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/22/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022]
Abstract
Introduction The ongoing global COVID-19 pandemic has dramatically impacted our lives. We conducted this systematic review to investigate the safety of the COVID-19 vaccines in NMOSD patients. Methods We systematically searched PubMed, Scopus, Web of Science, and Embase from the beginning of the COVID-19 vaccination to March 1, 2022. Except for the letters, posters, and reviews, we included all related articles to answer two main questions. Our first question examined the occurrence of NMOSD onset as an adverse effect of the COVID-19 vaccine. Our second question investigated the safety of the COVID-19 vaccines in NMOSD patients. Results Out of 262 records, nine studies, including five studies for the first question and four studies for the second question, met the inclusion criteria. Out of the six patients with NMOSD onset after COVID-19 vaccination, five (83.3%) were female. The median time to NMOSD onset was 6.5 days, and the frequency of the COVID-19 vaccine type was identical in all patients. The most common presentation was longitudinally extensive transverse myelitis, significantly improved by pulse methylprednisolone with or without plasma exchange. The maintenance therapy was described only in three patients: rituximab (n=2) and azathioprine (n=1). Regarding the second question, out of 67 patients, 77.61% were female, with a mean age of 54.75 years old, a mean EDSS of 2.83, and a mean disease duration of 9.5 years. 77% reported at least one preexisting comorbidity. 88.05% were under treatment, most of which were rituximab and azathioprine. 98.50% received two doses of the COVID-19 vaccine. mRNA vaccines were the most commonly used vaccine(86.56%), which were well tolerated. No significant adverse event was reported, and local pain was the most frequently reported. 4.67% of the patients experienced a clinical relapse after a mean interval of 49.75 days, which was mainly mild to moderate in severity. Unfortunately, the data on the COVID-19 vaccines were missing. Conclusion The analysis suggests the safety profile of the COVID-19 vaccines. All NMOSD patients are strongly recommended to vaccinate for COVID-19. To maximize the effectiveness of the COVID-19 vaccines, further studies are needed to draw the best practice for vaccination.
Collapse
Affiliation(s)
- Sepideh Paybast
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Emami
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Baghalha
- Medical Librarian, Clinical Research Developmental Center, Emam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdorreza Naser Moghadasi
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
16
|
Seirafianpour F, Pourriyahi H, Gholizadeh Mesgarha M, Pour Mohammad A, Shaka Z, Goodarzi A. A systematic review on mucocutaneous presentations after COVID-19 vaccination and expert recommendations about vaccination of important immune-mediated dermatologic disorders. Dermatol Ther 2022; 35:e15461. [PMID: 35316551 PMCID: PMC9111423 DOI: 10.1111/dth.15461] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/29/2022]
Abstract
With dermatologic side effects being fairly prevalent following vaccination against COVID-19, and the multitude of studies aiming to report and analyze these adverse events, the need for an extensive investigation on previous studies seemed urgent, in order to provide a thorough body of information about these post-COVID-19 immunization mucocutaneous reactions. To achieve this goal, a comprehensive electronic search was performed through the international databases including Medline (PubMed), Scopus, Cochrane, Web of science, and Google scholar on July 12, 2021, and all articles regarding mucocutaneous manifestations and considerations after COVID-19 vaccine administration were retrieved using the following keywords: COVID-19 vaccine, dermatology considerations and mucocutaneous manifestations. A total of 917 records were retrieved and a final number of 180 articles were included in data extraction. Mild, moderate, severe and potentially life-threatening adverse events have been reported following immunization with COVID vaccines, through case reports, case series, observational studies, randomized clinical trials, and further recommendations and consensus position papers regarding vaccination. In this systematic review, we categorized these results in detail into five elaborate tables, making what we believe to be an extensively informative, unprecedented set of data on this topic. Based on our findings, in the viewpoint of the pros and cons of vaccination, mucocutaneous adverse events were mostly non-significant, self-limiting reactions, and for the more uncommon moderate to severe reactions, guidelines and consensus position papers could be of great importance to provide those at higher risks and those with specific worries of flare-ups or inefficient immunization, with sufficient recommendations to safely schedule their vaccine doses, or avoid vaccination if they have the discussed contra-indications.
Collapse
Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Homa Pourriyahi
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | | | - Arash Pour Mohammad
- Student Research Committee, School of MedicineIran University of Medical SciencesTehranIran
| | - Zoha Shaka
- Faculty of MedicineIran University of Medical SciencesTehranIran
- Systematic Review and Meta‐Analysis Expert Group (SRMEG)Universal Scientific Education and Research NetworkTehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical SciencesTehranIran
| |
Collapse
|
17
|
Prabhu MM, Palaian S, Ansari M. Safety profile of COVID-19 vaccines, preventive strategies and patient management. Expert Rev Vaccines 2022; 21:1087-1095. [PMID: 35559718 DOI: 10.1080/14760584.2022.2078311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : Vaccines are the most critical tool currently available to combat the COVID-19 pandemic. Fast-track approval by regulatory authorities has led to serious concerns on the perception of COVID-19 vaccines' safety among the public. The most common adverse drug reactions (ADRs) of COVID-19 vaccines are minor localized reactions, while systemic ADRs have been reported rarely. The serious ADRs include anaphylaxis, vaccine-induced immune thrombotic thrombocytopenia syndrome (VITTS), and reactions related to the pharmaceutical excipients present in the vaccine. A comprehensive review on the safety of COVID-19 vaccines would help in early identification and better management of ADRs. This literature review was conducted using resources such as PubMed, Google Scholar, COVID-19 Vaccine package inserts and UpToDate. AREAS COVERED : This article provides various aspects of COVID-19 vaccine safety and offers strategies to prevent and clinically manage suspected ADRs related to COVID-19 vaccines. EXPERT OPINION : A careful consideration of contraindications and patient education on early identification of serious ADRs are the cornerstones in tackling safety concerns associated with COVID-19 vaccines. Most of the mild ADR cases are manageable with over-the-counter medications, while the serious ones may require physician oversight and hospitalization. It is also mandatory to report all ADRs to the local pharmacovigilance centers, with a higher priority given to the more significant ones, in order to improve vaccine safety data.
Collapse
Affiliation(s)
| | - Subish Palaian
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
| | - Mukhtar Ansari
- Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Saudi Arabia
| |
Collapse
|
18
|
Momenaei B, Cheraqpour K, Soleimani M, Tabatabaei SA, Shahriari M, Etesali H, Hussein A, Vaseghi Y, Ramezani B, Djalilian AR. Ophthalmic side effects of COVID-19 vaccines. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2066523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bita Momenaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Shahriari
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Etesali
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed Hussein
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Vaseghi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Ramezani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| |
Collapse
|
19
|
Cortes GM, Marcialis MA, Bardanzellu F, Corrias A, Fanos V, Mussap M. Inflammatory Bowel Disease and COVID-19: How Microbiomics and Metabolomics Depict Two Sides of the Same Coin. Front Microbiol 2022; 13:856165. [PMID: 35391730 PMCID: PMC8981987 DOI: 10.3389/fmicb.2022.856165] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/21/2022] [Indexed: 12/11/2022] Open
Abstract
The integrity of the gastrointestinal tract structure and function is seriously compromised by two pathological conditions sharing, at least in part, several pathogenetic mechanisms: inflammatory bowel diseases (IBD) and coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. IBD and COVID-19 are marked by gut inflammation, intestinal barrier breakdown, resulting in mucosal hyperpermeability, gut bacterial overgrowth, and dysbiosis together with perturbations in microbial and human metabolic pathways originating changes in the blood and fecal metabolome. This review compared the most relevant metabolic and microbial alterations reported from the literature in patients with IBD with those in patients with COVID-19. In both diseases, gut dysbiosis is marked by the prevalence of pro-inflammatory bacterial species and the shortfall of anti-inflammatory species; most studies reported the decrease in Firmicutes, with a specific decrease in obligately anaerobic producers short-chain fatty acids (SCFAs), such as Faecalibacterium prausnitzii. In addition, Escherichia coli overgrowth has been observed in IBD and COVID-19, while Akkermansia muciniphila is depleted in IBD and overexpressed in COVID-19. In patients with COVID-19, gut dysbiosis continues after the clearance of the viral RNA from the upper respiratory tract and the resolution of clinical symptoms. Finally, we presented and discussed the impact of gut dysbiosis, inflammation, oxidative stress, and increased energy demand on metabolic pathways involving key metabolites, such as tryptophan, phenylalanine, histidine, glutamine, succinate, citrate, and lipids.
Collapse
Affiliation(s)
- Gian Mario Cortes
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, Italy
| | - Maria Antonietta Marcialis
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, Italy
| | - Flaminia Bardanzellu
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, Italy
| | - Angelica Corrias
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, Italy
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, University of Cagliari, Monserrato, Italy
| | - Michele Mussap
- Laboratory Medicine, Department of Surgical Sciences, School of Medicine, University of Cagliari, Monserrato, Italy
| |
Collapse
|
20
|
Sung KY, Chang TE, Wang YP, Lin CC, Chang CY, Hou MC, Lu CL. SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systemic review and meta-analysis. J Chin Med Assoc 2022; 85:421-430. [PMID: 34974509 DOI: 10.1097/jcma.0000000000000682] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination has been effective in preventing COVID-19 infections and related mortality. The SARS-CoV-2 vaccination was also recommended by the international society for patients with inflammatory bowel disease (IBD). However, IBD patients were not recruited in prospective randomized clinical vaccine studies. To evaluate the efficacy and safety of SARS-CoV-2 vaccination in IBD patients, we conducted this systemic review and meta-analysis. METHODS We systematically searched PubMed, Medline, and the Cochrane Library for studies published between January 1, 2019, and September 9, 2021. Studies written in English reported the efficacy, seroconversion (anti-SARS-CoV-2 anti-spike (S) antibody titer beyond the threshold) rate, and adverse events after the SARS-CoV-2 vaccination in IBD patients. We extracted the author, date, study design, country, types of SARS-CoV-2 vaccination, number of IBD patients receiving SARS-CoV-2 vaccinations, and study outcomes. Published data from the enrolled studies were pooled to determine effect estimates. The study protocol was registered in PROSPERO (CRD42021264993). RESULTS We analyzed findings from 27 454 IBD patients who received SARS-CoV-2 vaccinations in 11 studies that met the inclusion criteria. The post-SARS-CoV-2 vaccination COVID-19 infection rate was comparable between the IBD patients and non-IBD patients (odds ratio [OR], 1.28 [95% CI, 0.96-1.71]) and higher in nonvaccinated IBD patients compared with vaccinated IBD patients (OR, 8.63 [95% CI, 5.44-13.37]). The adverse event rate, severe adverse events, and mortality after the SARS-CoV-2 vaccination were 69%, 3%, and 0%, respectively. CONCLUSION The SARS-CoV-2 vaccine is effective and tolerated in preventing COVID-19 infections in IBD patients. Over 98% of patients had seroconversion after receiving all doses of the SARS-CoV-2 vaccination, and the influence of biologics on vaccination was limited. The SARS-CoV-2 vaccination is recommended for IBD patients.
Collapse
Affiliation(s)
- Kuan-Yi Sung
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Tien-En Chang
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yen-Po Wang
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chun-Chi Lin
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Colon and Rectum Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chung-Yu Chang
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ming-Chih Hou
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ching-Liang Lu
- Endoscopy Center for Diagnosis and Treatment, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| |
Collapse
|
21
|
Gambichler T, Boms S, Susok L, Dickel H, Finis C, Abu Rached N, Barras M, Stücker M, Kasakovski D. Cutaneous findings following COVID-19 vaccination: review of world literature and own experience. J Eur Acad Dermatol Venereol 2022; 36:172-180. [PMID: 34661927 PMCID: PMC8656409 DOI: 10.1111/jdv.17744] [Citation(s) in RCA: 129] [Impact Index Per Article: 64.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/29/2021] [Indexed: 12/11/2022]
Abstract
There is growing evidence that not only the novel coronavirus disease (COVID-19) but also the COVID-19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID-19 vaccination campaigns all over the world. Unspecific injection-site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g. urticaria, angio-oedema and anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions ("COVID arm"), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly morbilliform and erythema multiforme-like rashes. Autoimmune-mediated skin findings after COVID-19 vaccination include leucocytoclastic vasculitis, lupus erythematosus and immune thrombocytopenia. Functional angiopathies (chilblain-like lesions, erythromelalgia) may also be observed. Pityriasis rosea-like rashes and reactivation of herpes zoster have also been reported after COVID-19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID-19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS-CoV-2 (e.g. the spike-protein sequences used to design the vaccines) and human components and may thus explain some COVID-19 pathologies as well as adverse skin reactions to COVID-19 vaccinations.
Collapse
Affiliation(s)
- T. Gambichler
- Department of DermatologyRuhr‐University BochumBochumGermany
- Department of DermatologyChristian Hospital UnnaUnnaGermany
| | - S. Boms
- Department of DermatologyChristian Hospital UnnaUnnaGermany
| | - L. Susok
- Department of DermatologyRuhr‐University BochumBochumGermany
| | - H. Dickel
- Department of DermatologyRuhr‐University BochumBochumGermany
| | - C. Finis
- Department of DermatologyRuhr‐University BochumBochumGermany
| | - N. Abu Rached
- Department of DermatologyRuhr‐University BochumBochumGermany
| | - M. Barras
- Department of DermatologyRuhr‐University BochumBochumGermany
| | - M. Stücker
- Department of DermatologyRuhr‐University BochumBochumGermany
| | - D. Kasakovski
- European Center for Angioscience (ECAS)Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Division of Vascular Oncology and MetastasisGerman Cancer Research Center Heidelberg (DKFZ‐ZMBH Alliance)HeidelbergGermany
| |
Collapse
|
22
|
Elkharsawi A, Arnim UV, Schmelz R, Sander C, Stallmach A, Teich N, Walldorf J, Reuken PA. SARS-CoV-2 vaccination does not induce relapses of patients with inflammatory bowel disease. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2022; 60:77-80. [PMID: 35042256 DOI: 10.1055/a-1710-3861] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vaccination against SARS-CoV-2 is a promising strategy to protect immunocompromised IBD patients from a severe course of COVID-19. As these patients were excluded from initial clinical vaccination trials, patients frequently express concerns regarding the safety of these vaccines, especially whether vaccination might trigger IBD flares ("hit-and-run-hypothesis"). METHODS In order to assess the risk of an IBD flare after vaccination against SARS-CoV-2, an anonymous survey was performed at five German IBD centers and one patient organization (Deutsche Morbus Crohn/Colitis ulcerosa Vereinigung (DCCV) e.V.) in August and October 2021. RESULTS The questionnaire was answered by 914 patients, 781 of whom reported a previous vaccination against SARS-CoV-2 (85.4%). Vaccination against SARS-CoV-2 was not associated with an increased risk of IBD flares (p=0.319) or unscheduled visits to the IBD physician (p=0.848). Furthermore, typical symptoms of an IBD flare including abdominal pain, increases in stool frequency, or rectal bleeding were not influenced by the vaccination. CONCLUSION Vaccination against SARS-CoV-2 is safe in IBD patients. These results may help to reduce fears regarding the vaccination in IBD patients. Our results can help to reduce fears in IBD patients regarding the SARS-CoV-2 vaccine. A close communication between patients and physicians before and after the vaccination may be beneficial.
Collapse
Affiliation(s)
- Ahmed Elkharsawi
- Department of Internal Medicine IV, Jena University Hospital, Jena, Germany
| | - Ulrike von Arnim
- Department of Gastroenterology, Hepatology and Infectious diseases, Universitätsklinikum Magdeburg AöR, Magdeburg, Germany
| | - Renate Schmelz
- Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | - Cornelia Sander
- Deutsche Morbus Crohn/Colitis Ulcerosa Vereinigung e.V., Berlin, Germany
| | - Andreas Stallmach
- Department of Internal Medicine IV, Jena University Hospital, Jena, Germany
| | - Niels Teich
- Internistische Gemeinschaftspraxis für Verdauungs- und Stoffwechselkrankheiten, Leipzig, Germany
| | - Jens Walldorf
- Department of Internal Medicine I, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Philipp A Reuken
- Department of Internal Medicine IV, Jena University Hospital, Jena, Germany
| |
Collapse
|
23
|
Invernizzi A. The impact of COVID-19 on the retina: clinical features and management considerations. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2021877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Alessandro Invernizzi
- Eye Clinic, Department of Biomedical and Clinical Sciences L. Sacco, Luigi Sacco Hospital, University of Milan, Milan, Italy
- The Discipline of Clinical Ophthalmology and Eye Health, Faculty of Medicine and Health, Save Sight Institute, Sydney Eye Hospital, The University of Sydney, Sydney, Australia
| |
Collapse
|
24
|
Doskaliuk B, Yatsyshyn R, Klishch I, Zimba O. COVID-19 from a rheumatology perspective: bibliometric and altmetric analysis. Rheumatol Int 2021; 41:2091-2103. [PMID: 34596719 PMCID: PMC8484846 DOI: 10.1007/s00296-021-04987-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/31/2021] [Indexed: 12/22/2022]
Abstract
The Coronavirus disease 2019 (COVID-19) outbreak turned out the greatest pandemic for decades. It challenged enormously the global health system, forcing it to adjust to the new realities. We aimed to analyze articles covering COVID-19 papers in the rheumatological field and outline emerging topics raising within this frame. We applied the bibliometric database Scopus for our literature search and conducted it on the 5th of June using the following keywords: "rheumatic" OR "rheumatology" OR "rheumatoid arthritis" OR "systemic lupus erythematosus" OR "myositis" OR "systemic sclerosis" OR "vasculitis" OR "arthritis" OR "ankylosing spondylitis" AND "COVID-19". We analyzed all selected articles according to various aspects: type of document, authorship, journal, citations score, rheumatology field, country of origin, language, and keywords. With the help of the software tool VOSviewer version 1.6.15, we have built the visualizing network of authors and keywords co-occurrence. The measurement of the social impact of articles was made using Altmetric data. This study included 1430 retrieved articles with open access mostly. The top five journals in this field were Annals of the Rheumatic Diseases (n = 65), Rheumatology International (n = 51), Clinical Rheumatology (n = 50), Lancet Rheumatology (n = 50), and Frontiers In Immunology (n = 33). Most studies originate from countries with a high incidence of COVID-19 among the general population (the USA-387; Italy-268; UK-184; France-114; Germany-110; India-98 and Spain-96, China-94, Canada-73 Turkey-66). Original Articles (42.1%) were the most common articles' type, following by Letters (24.4%), Reviews (21.7%), Notes (6%), Editorials (4.8%), Erratum (1%). According to the citations scores, articles dedicated to the clinical course of COVID-19 in patients with rheumatic diseases were of the highest importance for the scientific rheumatologic community. Rheumatoid arthritis (n = 527), systemic lupus erythematosus (n = 393), vasculitis (n = 267), myositis (n = 71), systemic sclerosis (n = 68), and psoriatic arthritis (n = 68) were the most widely discussed rheumatic diseases in the view of COVID-19. The analysis of Altmetric and citations scores revealed a moderate correlation between them. This article provides a comprehensive bibliometric and altmetric analysis of COVID-19 related articles in the rheumatology field and summarizes data about features of rheumatology service in the time of the pandemic.
Collapse
Affiliation(s)
- Bohdana Doskaliuk
- Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Halytska str. 2, Ivano-Frankivsk, 76000 Ukraine
| | - Roman Yatsyshyn
- Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Halytska str. 2, Ivano-Frankivsk, 76000 Ukraine
| | - Iryna Klishch
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Olena Zimba
- Department of Internal Medicine #2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| |
Collapse
|
25
|
Toscano S, Chisari CG, Patti F. Multiple Sclerosis, COVID-19 and Vaccines: Making the Point. Neurol Ther 2021; 10:627-649. [PMID: 34625925 PMCID: PMC8500471 DOI: 10.1007/s40120-021-00288-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/22/2021] [Indexed: 12/15/2022] Open
Abstract
On 11 March 2020, the World Health Organization declared the coronavirus disease 19 (COVID-19) outbreak a pandemic. In this context, several studies and clinical trials have been conducted since then, and many are currently ongoing, leading to the development of several COVID-19 vaccines with different mechanisms of action. People affected by multiple sclerosis (MS) have been considered high-risk subjects in most countries and prioritized for COVID-19 vaccination. However, the management of MS during the COVID-19 pandemic has represented a new challenge for MS specialists, particularly because of the initial lack of guidelines and differing recommendations. Despite an initial hesitation in prescribing disease-modifying drugs (DMDs) in naïve and already treated patients with MS, most national neurology associations and organizations agree on not stopping treatment. However, care is needed especially for patients treated with immune-depleting drugs, which also require some attentions in programming vaccine administration. Many discoveries and new research results have accumulated in a short time on COVID-19, resulting in a need for summarizing the existing evidence on this topic. In this review, we describe the latest research results on the immunological aspects of SARS-CoV-2 infection speculating about their impact on COVID-19 vaccines' mechanisms of action and focused on the management of MS during the COVID pandemic according to the most recent guidelines and recommendations. Finally, the efficacy of COVID-19 and other well-known vaccines against infectious disease in patients with MS on DMDs is discussed.
Collapse
Affiliation(s)
- Simona Toscano
- Department G. F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Clara G Chisari
- Department G. F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy
| | - Francesco Patti
- Department G. F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
| |
Collapse
|
26
|
D’Amelio R, Asero R, Cassatella MA, Laganà B, Lunardi C, Migliorini P, Nisini R, Parronchi P, Quinti I, Racanelli V, Senna G, Vacca A, Maggi E. Anti-COVID-19 Vaccination in Patients with Autoimmune-Autoinflammatory Disorders and Primary/Secondary Immunodeficiencies: The Position of the Task Force on Behalf of the Italian Immunological Societies. Biomedicines 2021; 9:1163. [PMID: 34572349 PMCID: PMC8465958 DOI: 10.3390/biomedicines9091163] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 02/06/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) pandemic has represented an unprecedented challenge for humankind from health, economic, and social viewpoints. In February 2020, Italy was the first western country to be deeply hit by the pandemic and suffered the highest case/fatality rate among western countries. Brand new anti-COVID-19 vaccines have been developed and made available in <1-year from the viral sequence publication. Patients with compromised immune systems, such as autoimmune-autoinflammatory disorders (AIAIDs), primary (PIDs) and secondary (SIDs) immunodeficiencies, have received careful attention for a long time regarding their capacity to safely respond to traditional vaccines. The Italian Immunological Societies, therefore, have promptly faced the issues of safety, immunogenicity, and efficacy/effectiveness of the innovative COVID-19 vaccines, as well as priority to vaccine access, in patients with AIADs, PIDs, and SIDs, by organizing an ad-hoc Task Force. Patients with AIADs, PIDs, and SIDs: (1) Do not present contraindications to COVID-19 vaccines if a mRNA vaccine is used and administered in a stabilized disease phase without active infection. (2) Should usually not discontinue immunosuppressive therapy, which may be modulated depending on the patient's clinical condition. (3) When eligible, should have a priority access to vaccination. In fact, immunizing these patients may have relevant social/health consequences, since these patients, if infected, may develop chronic infection, which prolongs viral spread and facilitates the emergence of viral variants.
Collapse
Affiliation(s)
- Raffaele D’Amelio
- Dipartimento di Medicina Clinica e Molecolare, Sapienza Università di Roma, Via di Grottarossa 1035-1039, 00189 Rome, Italy;
| | - Riccardo Asero
- Ambulatorio di Allergologia, Clinica S. Carlo di Paderno Dugnano, Via Ospedale 21, 20037 Milano, Italy;
| | - Marco Antonio Cassatella
- Sezione di Patologia Generale, Dipartimento di Medicina, Università di Verona, Strada Le Grazie 4, 37134 Verona, Italy;
| | - Bruno Laganà
- UOC Medicina Interna, Dipartimento di Medicina Clinica e Molecolare, AOU S. Andrea, Sapienza Università di Roma, Via di Grottarossa 1035-1039, 00189 Rome, Italy;
| | - Claudio Lunardi
- Responsabile Unità di Malattie Autoimmunitarie, Dipartimento di Medicina, AOU Policlinico G.B. Rossi, Borgo Roma, Università di Verona, Piazzale Ludovico Antonio Scuro 10, 37134 Verona, Italy;
| | - Paola Migliorini
- Direttore Unità Operativa di Immunoallergologia Clinica, Dipartimento di Medicina Clinica e Sperimentale, Azienda Ospedaliero Universitaria Pisana, Università di Pisa, Via Roma 67, 56126 Pisa, Italy;
| | - Roberto Nisini
- Direttore Reparto Immunologia, Dipartimento di Malattie Infettive, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Paola Parronchi
- Direttore SOD Immunologia e Terapie Cellulari, Dipartimento di Medicina Sperimentale e Clinica, AOU Careggi, Università di Firenze, Largo Brambilla 3, 50134 Firenze, Italy;
| | - Isabella Quinti
- Responsabile UOD Centro di Riferimento Regionale per le Immunodeficienze, Dipartimento di Medicina Molecolare, AOU Policlinico Umberto I, Sapienza Università di Roma, Viale dell’Università 37, 00161 Rome, Italy;
| | - Vito Racanelli
- UOC Medicina Interna “Guido Baccelli”, Dipartimento di Scienze Biomediche ed Oncologia Umana, AOU Policlinico, Università di Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Gianenrico Senna
- Direttore USD Allergologia, Dipartimento di Medicina, AOU Policlinico G.B. Rossi, Borgo Roma, Università di Verona, Piazzale Ludovico Antonio Scuro 10, 37134 Verona, Italy;
| | - Angelo Vacca
- Direttore UOC Medicina Interna “Guido Baccelli”, Dipartimento di Scienze Biomediche ed Oncologia Umana, AOU Policlinico, Università di Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Enrico Maggi
- Unità di Immunità Traslazionale, Dipartimento di Immunologia, Ospedale Pediatrico Bambino Gesù, IRCCS, Viale di S. Paolo 15, 00146 Rome, Italy
| |
Collapse
|
27
|
Català A, Muñoz-Santos C, Galván-Casas C, Roncero Riesco M, Revilla Nebreda D, Solá-Truyols A, Giavedoni P, Llamas-Velasco M, González-Cruz C, Cubiró X, Ruíz-Villaverde R, Gómez-Armayones S, Gil Mateo MP, Pesqué D, Marcantonio O, Fernández-Nieto D, Romaní J, Iglesias Pena N, Carnero Gonzalez L, Tercedor-Sanchez J, Carretero G, Masat-Ticó T, Rodríguez-Jiménez P, Gimenez-Arnau AM, Utrera-Busquets M, Vargas Laguna E, Angulo Menéndez AG, San Juan Lasser E, Iglesias-Sancho M, Alonso Naranjo L, Hiltun I, Cutillas Marco E, Polimon Olabarrieta I, Marinero Escobedo S, García-Navarro X, Calderón Gutiérrez MJ, Baeza-Hernández G, Bou Camps L, Toledo-Pastrana T, Guilabert A. Cutaneous reactions after SARS-COV-2 vaccination: A cross-sectional Spanish nationwide study of 405 cases. Br J Dermatol 2021; 186:142-152. [PMID: 34254291 PMCID: PMC8444756 DOI: 10.1111/bjd.20639] [Citation(s) in RCA: 151] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/05/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022]
Abstract
Background Cutaneous reactions after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines are poorly characterized. Objective To describe and classify cutaneous reactions after SARS‐CoV‐2 vaccination. Methods A nationwide Spanish cross‐sectional study was conducted. We included patients with cutaneous reactions within 21 days of any dose of the approved vaccines at the time of the study. After a face‐to‐face visit with a dermatologist, information on cutaneous reactions was collected via an online professional survey and clinical photographs were sent by email. Investigators searched for consensus on clinical patterns and classification. Results From 16 February to 15 May 2021, we collected 405 reactions after vaccination with the BNT162b2 (Pfizer‐BioNTech; 40·2%), mRNA‐1273 (Moderna; 36·3%) and AZD1222 (AstraZeneca; 23·5%) vaccines. Mean patient age was 50·7 years and 80·2% were female. Cutaneous reactions were classified as injection site (‘COVID arm’, 32·1%), urticaria (14·6%), morbilliform (8·9%), papulovesicular (6·4%), pityriasis rosea‐like (4·9%) and purpuric (4%) reactions. Varicella zoster and herpes simplex virus reactivations accounted for 13·8% of reactions. The COVID arm was almost exclusive to women (95·4%). The most reported reactions in each vaccine group were COVID arm (mRNA‐1273, Moderna, 61·9%), varicella zoster virus reactivation (BNT162b2, Pfizer‐BioNTech, 17·2%) and urticaria (AZD1222, AstraZeneca, 21·1%). Most reactions to the mRNA‐1273 (Moderna) vaccine were described in women (90·5%). Eighty reactions (21%) were classified as severe/very severe and 81% required treatment. Conclusions Cutaneous reactions after SARS‐CoV‐2 vaccination are heterogeneous. Most are mild‐to‐moderate and self‐limiting, although severe/very severe reactions are reported. Knowledge of these reactions during mass vaccination may help healthcare professionals and reassure patients. What is already known about this topic?In clinical trials, COVID‐19 vaccines were associated with cutaneous adverse events, especially local injection site reactions. Previous descriptions of cutaneous reactions beyond the injection site were case reports or mostly reported by non‐dermatologists and lacked clinical images.
What does this study add?We describe and classify a large, representative sample of patients with unexplained skin manifestations after COVID‐19 vaccination, using consensus to define associated morphological patterns. We describe six morphological reaction patterns and herpesvirus reactivations, and their association with demographic factors and the medical record, and provide illustrations to allow for easy recognition.
Linked Comment: V. Bataille and S. Puig. Br J Dermatol 2022; 186:15. Plain language summary available online
Collapse
Affiliation(s)
- A Català
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - C Muñoz-Santos
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
| | - C Galván-Casas
- Servicio de Dermatología. Hospital Universitario de Móstoles, Madrid, Spain
| | - M Roncero Riesco
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - D Revilla Nebreda
- Servicio de Dermatología. Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - A Solá-Truyols
- Servicio de Dermatología. Hospital Universitario Son Llatzer, Mallorca, Spain
| | - P Giavedoni
- Servicio de Dermatología. Hospital Clínic, Barcelona, Spain
| | - M Llamas-Velasco
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - C González-Cruz
- Servicio de Dermatología. Hospital, Universitari Vall D'Hebron, Barcelona, Spain
| | - X Cubiró
- Servicio de Dermatología. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - R Ruíz-Villaverde
- Servicio de Dermatología. Hospital Universitario San Cecilio, Granada, Spain
| | | | - M P Gil Mateo
- Servicio de Dermatología. Hospital General de La Palma. Santa Cruz de Tenerife, Spain
| | - D Pesqué
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - O Marcantonio
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | | | - J Romaní
- Servicio de Dermatología, Parc Taulí Hospital Universitari. Sabadell, Barcelona, Spain
| | - N Iglesias Pena
- Servicio de Dermatología. Hospital, Universitario Lucus Augusti, Lugo, Spain
| | | | | | - G Carretero
- Servicio de Dermatología.Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas Gran Canaria, Spain
| | - T Masat-Ticó
- CAP Cardedeu. Institut Català de la Salut, Barcelona, Spain
| | - P Rodríguez-Jiménez
- Servicio de Dermatología. Hospital Universitario de La Princesa, Madrid, Spain
| | - A M Gimenez-Arnau
- Servicio de Dermatología. Hospital del Mar. IMIM, Universitat Autònoma, Barcelona, Spain
| | - M Utrera-Busquets
- Servicio de Dermatología. Hospital Comarcal Infanta Elena, Huelva, Spain
| | - E Vargas Laguna
- Servicio de Dermatología. Hospital, Universitario Severo Ochoa, Madrid, Spain
| | - A G Angulo Menéndez
- Servicio de Dermatología. Serveis Medics Penedés Vilanova i la Geltrú, Barcelona, Spain
| | | | - M Iglesias-Sancho
- Servicio de Dermatología. Hospital, Universitari Sagrat Cor, Barcelona, Spain
| | - L Alonso Naranjo
- Servicio de Dermatología. Hospital Universitario de Toledo, Toledo, Spain
| | - I Hiltun
- Servicio de Dermatología, Complejo Hospitalario de Navarra, Navarra, Spain
| | - E Cutillas Marco
- Servicio de Dermatología. Hospital General, Universitario Reina Sofia, Murcia, Spain
| | | | | | - X García-Navarro
- Servicio de Dermatología. Consorci Sanitari Alt Penedès-Garraf, Barcelona, Spain
| | | | - G Baeza-Hernández
- Servicio de Dermatología. Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - A Guilabert
- Servicio de Dermatología. Hospital General de Granollers, Barcelona, Spain
| |
Collapse
|
28
|
Papasavvas I, Herbort CP. Reactivation of Vogt-Koyanagi-Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination. J Ophthalmic Inflamm Infect 2021; 11:21. [PMID: 34224024 PMCID: PMC8256412 DOI: 10.1186/s12348-021-00251-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/PURPOSE Vogt-Koyanagi-Harada (VKH) disease is a primary stromal choroiditis with bilateral granulomatous panuveitis. If initial-onset VKH is treated early and relentlessly the disease can be controlled and even "cured" in a substantial number of cases. We are reporting on a patient treated early and in a sustained fashion who was inflammation free for seven years but who presented a reactivation 6 weeks after the second dose of anti-SARS-CoV-2 vaccination. CASE REPORT A 43-year-old woman presented with severe initial-onset VKH disease which was brought under control using steroidal and non-steroidal Immunosuppression (mycophenolic acid and cyclosporine) with additional infliximab infusions because of the persistence of subclinical choroiditis identified on ICGA. Under infliximab alone disease had been inflammation free with no subclinical disease and absence of sunset glow fundus for 6 years. However, following anti-SARS-CoV-2 vaccination, severe resurgence of the disease occurred with exudative retinal detachments. Disease was rapidly brought again under control with oral prednisone (1 mg/kg) therapy and a new loading scheme of infliximab therapy. CONCLUSION VKH disease results from an autoimmune process directed against melanocyte associated antigens which can be controlled when early and sustained immunosuppressive treatment is introduced. It seems that anti-SARS-CoV-2 vaccination can be at the origin of reactivation of long-time controlled disease.
Collapse
Affiliation(s)
- Ioannis Papasavvas
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Teaching Centre Clinic Montchoisi, Lausanne, Switzerland
| | - Carl P Herbort
- Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Teaching Centre Clinic Montchoisi, Lausanne, Switzerland.
| |
Collapse
|
29
|
Chu CY, Lee CH, Huang YH. Taiwan dermatological association recommendations for coronavirus disease of 2019 vaccination in patients treated with immunotherapeutics. DERMATOL SIN 2021. [DOI: 10.4103/ds.ds_50_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|