Camargo-Coronel A, Quiñones-Moya H, Hernández-Zavala M R, Hernández-Vázquez J R, Vázquez-Zaragoza M Á
Rheumatology Department, Centro Médico Nacional Siglo XXI, Mexico City.
Reumatismo. 2023 May 8;75(1). doi: 10.4081/reumatismo.2023.1548.
The COVID-19 pandemic represents a global health problem, which has been mitigated by the opportune introduction of vaccination programs. Although we already know the benefit that vaccines provide, these are not exempt from adverse events which can be mild to deadly, such as idiopathic inflammatory myopathies, in which a temporal association has not been defined. It is for this reason that we carried out a systematic review of all reported cases of vaccination against COVID-19 and myositis. To identify previously reported cases of idiopathic inflammatory myopathies associated with vaccination against SARS-CoV-2 we registered this protocol on the website of PROSPERO with identification number CRD42022355551. Of the 63 publications identified in MEDLINE and 117 in Scopus, 21 studies were included, reporting 31 cases of patients with vaccination-associated myositis. Most of these cases were women (61.3%); mean age was 52.3 years (range 19-76 years) and mean time of symptom onset post-vaccination was 6.8 days. More than half of the cases were associated with Comirnaty, 11 cases (35.5%) were classified as dermatomyositis, and 9 (29%) as amyopathic dermatomyositis. In 6 (19.3%) patients another probable trigger was identified. Case reports of inflammatory myopathies associated with vaccination have heterogeneous presentations without any specific characteristics: as a consequence, it is not possible to ensure a temporal association between vaccination and the development of inflammatory myopathies. Large epidemiological studies are required to determine the existence of a causal association.
新冠疫情是一个全球性的健康问题，适时推出的疫苗接种计划缓解了这一问题。尽管我们已经知道疫苗带来的益处，但它们并非没有不良事件，这些不良事件可能从轻微到致命，比如特发性炎性肌病，其与疫苗接种的时间关联尚未明确。正是出于这个原因，我们对所有报告的新冠疫苗接种和肌炎病例进行了系统回顾。为了识别先前报告的与接种新冠病毒疫苗相关的特发性炎性肌病病例，我们在PROSPERO网站上注册了该方案，识别号为CRD42022355551。在MEDLINE数据库中识别出的63篇出版物和Scopus数据库中识别出的117篇出版物中，纳入了21项研究，报告了31例疫苗接种相关肌炎患者。这些病例大多数为女性（61.3%）；平均年龄为52.3岁（范围19 - 76岁），接种疫苗后症状出现的平均时间为6.8天。超过一半的病例与辉瑞新冠疫苗（Comirnaty）有关，11例（35.5%）被归类为皮肌炎，9例（29%）为无肌病性皮肌炎。在6例（19.3%）患者中确定了另一个可能的触发因素。与疫苗接种相关的炎性肌病病例报告呈现出异质性，没有任何特定特征：因此，无法确保疫苗接种与炎性肌病的发生之间存在时间关联。需要大型流行病学研究来确定因果关联是否存在。
