Hoffmann-Vold Anna-Maria, Distler Oliver, Bruni Cosimo, Denton Christopher P, de Vries-Bouwstra Jeska, Matucci Cerinic Marco, Vonk Madelon C, Gabrielli Armando
Department of Rheumatology, Oslo University Hospital, Oslo, Norway.
Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Lancet Rheumatol. 2022 Aug;4(8):e566-e575. doi: 10.1016/S2665-9913(22)00130-8. Epub 2022 Jul 21.
The COVID-19 pandemic represents one of the biggest challenges of the 21st century. In addition to the general effect on society and health-care systems, patients with systemic sclerosis and their physicians face specific challenges related to the chronic nature of their disease, the involvement of multiple organs, and the use of immunosuppressive treatments. Data from registries and single centre cohorts indicate that the risk of contracting SARS-CoV-2 does not seem to increase substantially in people with systemic sclerosis; conversely, severe COVID-19 outcomes are seen more frequently in these patients than in the general population. Vaccination against SARS-CoV-2 is therefore highly recommended for patients with systemic sclerosis; however, no specific recommendations are available regarding the different vaccine platforms. Both patients and physicians should be aware that the effectiveness of vaccines might be reduced in patients taking immunosuppressive therapy, because antibody responses might be blunted, specifically in patients treated with rituximab and mycophenolate mofetil.
2019年冠状病毒病（COVID-19）大流行是21世纪最大的挑战之一。除了对社会和医疗保健系统产生的总体影响外，系统性硬化症患者及其医生还面临与疾病的慢性性质、多器官受累以及免疫抑制治疗的使用相关的特定挑战。来自登记处和单中心队列的数据表明，系统性硬化症患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险似乎并未大幅增加；相反，这些患者中出现COVID-19严重后果的情况比普通人群更为常见。因此，强烈建议系统性硬化症患者接种SARS-CoV-2疫苗；然而，对于不同的疫苗平台尚无具体建议。患者和医生都应意识到，接受免疫抑制治疗的患者疫苗的有效性可能会降低，因为抗体反应可能会减弱，特别是在用利妥昔单抗和霉酚酸酯治疗的患者中。
