Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Allergy Clin Immunol Pract. 2023 Aug;11(8):2403-2410. doi: 10.1016/j.jaip.2023.04.050. Epub 2023 May 12.
The rapid development and rollout of vaccines against coronavirus disease 2019 (COVID-19) has led to more than half of the world's population being vaccinated to date. Real-world data have reported various adverse cutaneous reactions, including delayed-onset urticaria, which was highly ranked as a common manifestation across studies. However, the impact of these novel mRNA or viral vector COVID-19 vaccines on preexisting chronic spontaneous urticaria (CSU) remains largely unknown.
To investigate the impact of COVID-19 vaccination on the clinical status of patients with relatively stable CSU who are undergoing omalizumab treatment and to identify risk factors for exacerbation.
We conducted a questionnaire-based cross-sectional study in a tertiary hospital. Adult patients with relatively stable CSU under regular omalizumab treatments who had received at least one COVID-19 vaccination were included.
There were 105 study subjects who received 230 COVID-19 vaccinations between March and December 2021. Fifteen patients (14.3%) experienced aggravation of urticaria at least once after COVID-19 vaccination. The demographics and clinical characteristics of the patients were comparable regardless of the exacerbation of CSU. However, case-level analysis revealed that the presence of urticaria (vs none) before vaccination (odds ratio [OR] = 4.99; 95% CI, 1.57-15.82) and the development of systemic reactogenicity (OR = 4.57; 95% CI, 1.62-12.90) were associated with a higher risk for exacerbation.
The novel COVID-19 vaccination induced exacerbation in more than one-tenth of patients with well-controlled CSU. The establishment of a proper management strategy during COVID-19 vaccination is necessary for patients with CSU.
针对 2019 年冠状病毒病（COVID-19）的疫苗迅速开发和推出，迄今为止，世界上超过一半的人口已接种疫苗。 真实世界的数据报告了各种不良皮肤反应，包括迟发性荨麻疹，这在研究中被高度列为常见表现。 然而，这些新型 mRNA 或病毒载体 COVID-19 疫苗对先前存在的慢性自发性荨麻疹（CSU）的影响在很大程度上仍然未知。
研究 COVID-19 疫苗接种对正在接受奥马珠单抗治疗且病情相对稳定的 CSU 患者临床状况的影响，并确定加重的危险因素。
我们在一家三级医院进行了一项基于问卷调查的横断面研究。 纳入了接受至少一次 COVID-19 疫苗接种且正在接受常规奥马珠单抗治疗的病情相对稳定的 CSU 成年患者。
在 2021 年 3 月至 12 月期间，共有 105 例研究对象接受了 230 次 COVID-19 疫苗接种。 15 名患者（14.3%）在 COVID-19 疫苗接种后至少有一次荨麻疹加重。 无论 CSU 是否加重，患者的人口统计学和临床特征均无差异。 然而，病例水平分析显示，接种前存在荨麻疹（与无荨麻疹相比）（优势比[OR] = 4.99；95%CI，1.57-15.82）和全身反应性（OR = 4.57；95%CI，1.62-12.90）与加重的风险更高相关。
新型 COVID-19 疫苗接种可使十分之一以上病情控制良好的 CSU 患者病情加重。 对于 CSU 患者，在 COVID-19 疫苗接种期间制定适当的管理策略是必要的。
