Tang Kuo-Tung, Hsu Bo-Chueh, Chen Der-Yuan
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan.
Biomedicines. 2022 Apr 1;10(4):834. doi: 10.3390/biomedicines10040834.
Vaccination is one of the most important measures worldwide to halt the spread of the corona virus disease 2019 (COVID-19). However, the efficacy and safety of these vaccines in rheumatic patients are not well explored. Therefore, we conducted a systematic review and meta-analysis.
We performed a literature search of the PubMed and EMBASE databases on 17 November 2021. Forty-seven studies relevant to the immunogenicity, efficacy/effectiveness, and safety of COVID-19 vaccines were selected.
Our results demonstrated that COVID-19 vaccination is effective in protecting rheumatic patients from severe illness caused by the virus. Both the humoral and cellular immunogenicity of vaccines were impaired in rheumatic patients, which were greatly enhanced after the second vaccine dose. Receiving anti-CD20 therapy was associated with impaired humoral immunogenicity. Adverse events due to COVID-19 vaccines in rheumatic patients were similar to those in healthy controls, except for an increased incidence of arthralgia. The incidence of disease flares after COVID-19 vaccination was low.
Our systematic review indicated the importance of full vaccination in rheumatic patients. Withholding anti-CD20 therapy was found to be potentially beneficial for the immunogenicity. Furthermore, the vaccines were found to be safe in general. Despite significant heterogeneity between studies, we recommend that rheumatic patients receive these vaccines amidst the global pandemic.
接种疫苗是全球范围内阻止2019冠状病毒病（COVID-19）传播的最重要措施之一。然而，这些疫苗在风湿性疾病患者中的疗效和安全性尚未得到充分研究。因此，我们进行了一项系统评价和荟萃分析。
我们于2021年11月17日在PubMed和EMBASE数据库中进行了文献检索。选取了47项与COVID-19疫苗的免疫原性、疗效/有效性及安全性相关的研究。
我们的结果表明，接种COVID-19疫苗可有效保护风湿性疾病患者免受该病毒所致的重症。疫苗的体液免疫原性和细胞免疫原性在风湿性疾病患者中均受损，在接种第二剂疫苗后显著增强。接受抗CD20治疗与体液免疫原性受损相关。除关节痛发生率增加外，风湿性疾病患者接种COVID-19疫苗后的不良事件与健康对照者相似。COVID-19疫苗接种后疾病复发的发生率较低。
我们的系统评价表明了在风湿性疾病患者中全程接种疫苗的重要性。停用抗CD20治疗可能对免疫原性有益。此外，总体而言这些疫苗是安全的。尽管研究之间存在显著异质性，但我们建议风湿性疾病患者在全球大流行期间接种这些疫苗。
