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Flares after COVID-19 infection in patients with idiopathic inflammatory myopathies: results from the COVAD study
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Rheumatology | April 2, 2023 | Volume: 62 | Issue: 9 | Pages: e263-e268
Flares in autoimmune rheumatic diseases in the post-COVID-19 vaccination period—a cross-sequential study based on COVAD surveys
Jagtap, Kshitij , Naveen, R, Day, Jessica , Sen, Parikshit , Vaidya, Binit , Nune, Arvind , Nikiphorou, Elena , Tan, Ai Lyn , Agarwal, Vishwesh , Saha, Sreoshy , Ziadé, Nelly , Velikova, Tsvetelina , Milchert, Marcin , Parodis, Ioannis , Kuwana, Masataka , Makol, Ashima , Patel, Aarat , Pauling, John D , Wincup, Chris , Tehozol, Erick Adrian Zamora , Chibuzo, Okwara Celestine , Katchamart, Wanruchada , Goo, Phonpen Akawatcharangura , Shumnalieva, Russka , Kibbi, Lina El , Halabi, Hussein , Shaharir, Syahrul Sazliyana , Hasan, A T M Tanveer , Dey, Dzifa , Gutiérrez, Carlos Enrique Toro , Caballero‐Uribe, Carlo V. , Salim, Babur , Gheita, Tamer A. , Group, COVAD Study, Kardeş, Sinan , Schreiber, Karen, Vince, Melinda Nagy, Singh, Yogesh Preet , Ranjan, Rajiv , Jain, Avinash , Pandya, Sapan C , Sharma, Aman , Manoj, Manesh , Patro, Pradeepta Sekhar , Ajmani, Sajal , Chowdhury, Abhra Chandra , Shenoy, Padnamabha, Bommakanti, Keerthi Talari, Shukla, Anuj , Ghodke, Akanksha, Fazal, Zoha Zahid , Yıldırım, Reşit , Atzeni, Fabiola , Bocci, Elena Bartoloni, Sebastiani, Marco, Orsolini, Giovanni , Angelis, Rossella De , Danielli, Maria Giovanna, Grignaschi, Silvia, Alluno, Alessia, Ioannone, Florenzo, Prieto‐González, Sergio , Nakashima, Ran , Sato, Shinji , Kaneko, Yuko , Gono, Takahisa, Tomaras, Stylianos , Aharonov, Or, Bouchti, I. El , Baba, Zineb, Maurier, François, Meyer, Alain , Limaye, Vidya , Hudson, Marie , Landon‐Cardinal, Océane , Zuleta, Wilmer Gerardo Rojas, Cajas, Javier, Silva, José António Pereira, Ima-Edomwonyi, Uyi, Dedeke, Ibukunoluwa, Madu, Nwankwo Henry, Yerima, Abubakar , Becky, A, Koussougbo, Oruma Devi, Palalane, Elisa, Chinchay, Lyn , Bernaola, José Proaño, Pimentel, Victorio, Fathi, Hanan Mohammed, Harifi, Ghita, Cabriza, Karoll, Losanto, Jonathan, Colaman, Nelly, Cachafeiro-Vilar, Antonio , Bautista, Generoso Guerra , Ho, Enrique Julio Giraldo, Nunez, Lilith Stange, Vergara, M Cristian, Báez, Jossiell Then , Alonzo, Hugo, Pastelin, Carlos Benito Santiago, Obiols, Alejandro Quiñónez, Chávez, Nilmo , Ordóñez, Andrea Bran , Argueta, Sandra, Llerena, Gil Alberto Reyes, Sierra-Zorita, Radames, Arrieta, Dina , Hidalgo, Eduardo Romero, Saénz, Ricardo, Escalante, Miguel , Calapaqui, Wendy, Quezada, Ivonne, Arredondo, Gabriela, Chinoy, Hector , Agarwal, Vikas , Gupta, Latika, Ravichandran, Naveen , Gupta, Latika , Naveen, R , Shinjo, Samuel Katsuyuki , Ziade, Nelly , Joshi, Mrudula , Velikova, Tsvetelina , Milchert, Marcin , Parodis, Ioannis , Gracia-Ramos, Abraham Edgar , Cavagna, Lorenzo , Kuwana, Masataka , Knitza, Johannes , Makol, Ashima , Pauling, John D , Wincup, Chris , Barman, Bhupen , Zamora Tehozol, Erick Adrian , Rojas Serrano, Jorge , García-De La Torre, Ignacio , Colunga-Pedraza, Iris J , Merayo-Chalico, Javier , Chibuzo, Okwara Celestine , Katchamart, Wanruchada , Shumnalieva, Russka , Chen, Yi-Ming , Hoff, Leonardo Santos , El Kibbi, Lina , Halabi, Hussein , Sazliyana Shaharir, Syahrul , Hasan, A T M Tanveer , Dey, Dzifa , Gutiérrez, Carlos Enrique Toro , Caballero-Uribe, Carlo Vinicio , Lilleker, James B , Salim, Babur , Gheita, Tamer , Chatterjee, Tulika , Saavedra, Miguel A , Distler, Oliver , Chinoy, Hector , Agarwal, Vikas , Aggarwal, Rohit , Gupta, Latika , Agarwal, Vishwesh , Day, Jessica , Tan, Ai Lyn , Nune, Arvind , Sen, Parikshit , Saha, Sreoshy , Jagtap, Kshitij , De Angelis, Rossella , Singh, Yogesh Preet , Shinjo, Samuel Katsuyuki , Joshi, Mrudula , Gracia‐Ramos, Abraham Edgar , Torre, Ignacio García‐De La , Colunga-Pedraza, I. J. , Chen, Yi‐Ming , Chatterjee, Tulika , Distler, Oliver , Group, COVAD Study, Griger, Zoltán , Andréoli, Laura , Lini, Daniele , Schreiber, Karen , Pilania, Rakesh Kumar , Gupta, Vikas , Kavadichanda, Chengappa G. , Phatak, Sanat B. , Goswami, Rudra P , Mathew, Ashish Jacob , Asranna, Ajay , Pande, Arun K. , Chandwar, Kunal , Boro, Hiya , Cansu, Döndü Üsküdar , Gasparyan, Armen Yuri , Papa, Nicoletta Del , Sambataro, Gianluca , Govoni, Marcello , Parisi, Simone , Bocci, Elena Bartoloni, Sebastiani, Gian Domenico , Fusaro, Enrico , Sebastiani, Marco, Quartuccio, Luca , Franceschini, Franco , Sainaghi, Pier Paolo , Venerito, Vincenzo , Giollo, Alessandro , Fornaro, Marco , Traboco, Lisa S , Wibowo, Suryo Anggoro Kusumo , Loarce‐Martos, Jesus , Gonzalez, Raquel Aranega, Yoshida, Akira , Kimura, Naoki, Proft, Fabian Nikolai , Holzer, Marie‐Therese , Gromova, Margarita Aleksandrovna , Hmamouchi, Ihsane , Baba, Zineb, Giannini, Margherita , Maurier, F. , Campagne, Julien , Langguth, Daman , Needham, Merrilee , Srivastav, Nilesh , Arbeláez-Cortés, Álvaro , Cajas, Javier, Silva, José António Pereira, Fonseca, João Eurico , Zimba, Olena , Doskaliuk, Bohdana , Ima-Edomwonyi, Uyi, Emorinken, Airenakho , Olaosebikan, Hakeem , So, Ho , Ugarte‐Gil, Manuel F. , Mohammed, Reem Hamdy A , Harifi, Ghita , Fuentes-Silva, Yurilís , Salinas, Rodrigo Nicolás Garcia , Aggarwal, Rohit
Rheumatology | March 24, 2023 | Volume: 62 | Issue: 12 | Pages: 3838-3848
Abstract Objective Flares of autoimmune rheumatic diseases (AIRDs) following COVID-19 vaccination are a particular concern in vaccine-hesitant individuals. Therefore, we investigated the incidence, predictors and patterns of flares following vaccination in individuals living with AIRDs, using global COVID-19 Vaccination in Autoimmune Diseases (COVAD) surveys. Methods The COVAD surveys were used to extract data on flare demographics, comorbidities, COVID-19 history, and vaccination details for patients with AIRDs. Flares following vaccination were identified as patient-reported (a), increased immunosuppression (b), clinical exacerbations (c) and worsening of PROMIS scores (d). We studied flare characteristics and used regression models to differentiate flares among various AIRDs. Results Of 15 165 total responses, the incidence of flares in 3453 patients with AIRDs was 11.3%, 14.8%, 9.5% and 26.7% by definitions a–d, respectively. There was moderate agreement between patient-reported and immunosuppression-defined flares (K = 0.403, P = 0.022). Arthritis (61.6%) and fatigue (58.8%) were the most commonly reported symptoms. Self-reported flares were associated with higher comorbidities (P = 0.013), mental health disorders (MHDs) (P < 0.001) and autoimmune disease multimorbidity (AIDm) (P < 0.001). In regression analysis, the presence of AIDm [odds ratio (OR) = 1.4; 95% CI: 1.1, 1.7; P = 0.003), or a MHD (OR = 1.7; 95% CI: 1.1, 2.6; P = 0.007), or being a Moderna vaccine recipient (OR = 1.5; 95% CI: 1.09, 2.2; P = 0.014) were predictors of flares. Use of MMF (OR = 0.5; 95% CI: 0.3, 0.8; P = 0.009) and glucocorticoids (OR = 0.6; 95% CI: 0.5, 0.8; P = 0.003) were protective. A higher frequency of patients with AIRDs reported overall active disease post-vaccination compared with before vaccination (OR = 1.3; 95% CI: 1.1, 1.5; P < 0.001). Conclusion Flares occur in nearly 1 in 10 individuals with AIRDs after COVID vaccination; people with comorbidities (especially AIDm), MHDs and those receiving the Moderna vaccine are particularly vulnerable. Future avenues include exploring flare profiles and optimizing vaccine strategies for this group.