Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Hungary.
Clin Exp Rheumatol. 2023 Mar;41(2):254-260. doi: 10.55563/clinexprheumatol/eisexh. Epub 2022 Jul 21.
Pandemic caused by coronavirus disease (COVID-19) determines the life of clinicians and patients since 2 years. We have a lot of information about disease course, treatment and protection against virus, but less on the prognosis of infection in patients with idiopathic inflammatory myopathies (IIM). Also few data are available on triggered humoral response and side effects after vaccination.
Our goal was to assess by a retrospective cross-sectional study the above data in our cohort (176 IIM patients) by identifying COVID-19 positive patients and follow disease course. Incidence and complications of vaccination were determined by questionnaires. 101 patients volunteered for complex blood test.
By June 1st, 2021 significantly higher incidence of COVID 19 infections (34.7%) were identified comparing to the national prevalence (8.2%). A third of these infections occurred asymptomatically or mild. Patients requiring hospitalisation had a significantly longer disease duration and a higher incidence of anti-Jo-1 antibody. All patients infected by COVID-19 became seropositive regardless the immunosuppressive therapy or symptoms severity. 54.3% of the patients received anti-COVID-19 vaccine. 72.3% of patients became seropositive after vaccination. Higher antibody titer against spike protein was detected after Pfizer-BioNTech vaccination compared to others. Patients receiving steroid therapy had decreased post-vaccination antibody response compared to those without steroid treatment. No major post-vaccination infection was observed.
Based on our results, myositis may be associated with an increased risk of COVID-19 infection. Independent risk factor for hospitalisation are longer disease duration and anti-Jo1 positivity. Anti-SARS-CoV2 vaccines seem safe and tolerable and strongly recommended for that population.
由冠状病毒病（COVID-19）引起的大流行自 2 年前以来一直决定着临床医生和患者的生活。我们有很多关于疾病过程、治疗和病毒防护的信息，但关于特发性炎症性肌病（IIM）患者感染的预后知之甚少。接种疫苗后引发的体液反应和副作用的数据也很少。
我们通过回顾性横断面研究，在我们的队列（176 例 IIM 患者）中评估上述数据，确定 COVID-19 阳性患者并随访疾病过程。通过问卷调查确定疫苗接种的发生率和并发症。101 名患者自愿接受了复杂的血液检查。
截至 2021 年 6 月 1 日，与全国流行率（8.2%）相比，COVID-19 感染的发病率（34.7%）明显更高。其中三分之一的感染无症状或轻度。需要住院治疗的患者疾病持续时间明显更长，抗 Jo-1 抗体的发生率更高。所有感染 COVID-19 的患者均转为血清阳性，无论免疫抑制治疗或症状严重程度如何。54.3%的患者接种了抗 COVID-19 疫苗。72.3%的患者接种疫苗后呈血清阳性。与其他疫苗相比，接种辉瑞-生物科技疫苗后检测到针对刺突蛋白的抗体滴度更高。与未接受类固醇治疗的患者相比，接受类固醇治疗的患者接种疫苗后的抗体反应降低。未观察到重大接种后感染。
根据我们的结果，肌炎可能与 COVID-19 感染风险增加有关。住院的独立危险因素是疾病持续时间较长和抗 Jo1 阳性。抗 SARS-CoV2 疫苗似乎是安全且耐受的，强烈建议该人群接种。
