Kan Andy Ka Chun, Wong Thomas Tsz Hang, Chiang Valerie, Lau Chak Sing, Li Philip Hei
Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Hong Kong.
Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong.
Allergy Asthma Immunol Res. 2023 Jan;15(1):32-42. doi: 10.4168/aair.2023.15.1.32.
The real-world management and clinical characteristics of chronic spontaneous urticaria (CSU) in Hong Kong and its implications for coronavirus disease 2019 (COVID-19) vaccination are unknown. We investigated the clinical characteristics of patients with CSU and the role of an immunologist-led Urticaria Clinic as well as the impact of CSU on COVID-19 vaccine uptake in Hong Kong.
Longitudinal clinical data of 257 CSU patients were collected and analyzed. Association analyses were performed to identify the relationships between variables and factors associated with COVID-19 vaccine uptake.
After the immunologist review, the Weekly Urticaria Activity Score (UAS7) was significantly lower than baseline (median: 0.00 vs. 12.0, < 0.001). Changes in UAS7 were significantly greater among patients with baseline UAS7 ≥ 16 compared to those with UAS7 < 16 (median: -24.0 vs. -2.00, < 0.001). CSU patients had lower COVID-19 vaccination rates than the general population with only 176 (68.5%) and 165 (65.0%) receiving at least one dose and 2 doses of vaccination, respectively. The presence of concomitant suspected drug allergy was associated with lower COVID-19 vaccine uptake (odds ratio [OR], 0.47; = 0.010), while regular pharmacological treatment was associated with higher COVID-19 vaccine uptake among CSU patients (OR, 3.79; = 0.010).
A dedicated immunologist-led Urticaria Clinic may effectively improve CSU management and outcomes in Hong Kong.
香港慢性自发性荨麻疹（CSU）的实际管理情况、临床特征及其对2019冠状病毒病（COVID-19）疫苗接种的影响尚不清楚。我们调查了CSU患者的临床特征、免疫学家主导的荨麻疹诊所的作用以及CSU对香港COVID-19疫苗接种率的影响。
收集并分析了257例CSU患者的纵向临床数据。进行关联分析以确定与COVID-19疫苗接种相关的变量和因素之间的关系。
经过免疫学家评估后，每周荨麻疹活动评分（UAS7）显著低于基线水平（中位数：0.00对12.0，<0.001）。与基线UAS7<16的患者相比，基线UAS7≥16的患者UAS7的变化显著更大（中位数：-24.0对-2.00，<0.001）。CSU患者的COVID-19疫苗接种率低于普通人群，分别只有176例（68.5%）和165例（65.0%）接受了至少一剂和两剂疫苗接种。伴有疑似药物过敏与较低的COVID-19疫苗接种率相关（比值比[OR]，0.47；=0.010），而规律的药物治疗与CSU患者较高的COVID-19疫苗接种率相关（OR，3.79；=0.010）。
在香港，由免疫学家主导的专门荨麻疹诊所可能有效改善CSU的管理和治疗效果。
