Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, sala 3190 - Cerqueira César, São Paulo, SP, 01246-903, Brazil.
Pediatric Rheumatology Unit, Instituto da Criança e do Adolescente, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil.
Adv Rheumatol. 2023 Jun 8;63(1):26. doi: 10.1186/s42358-023-00309-z.
Data on post-acute COVID-19 in autoimmune rheumatic diseases (ARD) are scarce, focusing on a single disease, with variable definitions of this condition and time of vaccination. The aim of this study was to evaluate the frequency and pattern of post-acute COVID-19 in vaccinated patients with ARD using established diagnosis criteria.
Retrospective evaluation of a prospective cohort of 108 ARD patients and 32 non-ARD controls, diagnosed with SARS-CoV-2 infection (RT-PCR/antigen test) after the third dose of the CoronaVac vaccine. Post-acute COVID-19 (≥ 4 weeks and > 12 weeks of SARS-CoV-2 symptoms) were registered according to the established international criteria.
ARD patients and non-ARD controls, balanced for age and sex, had high and comparable frequencies of ≥ 4 weeks post-acute COVID-19 (58.3% vs. 53.1%, p = 0.6854) and > 12 weeks post-acute COVID-19 (39.8% vs. 46.9%, p = 0.5419). Regarding ≥ 4 weeks post-acute COVID-19, frequencies of ≥ 3 symptoms were similar in ARD and non-ARD controls (54% vs. 41.2%, p = 0.7886), and this was also similar in > 12 weeks post-acute COVID-19 (68.3% vs. 88.2%, p = 0.1322). Further analysis of the risk factors for ≥ 4 weeks post-acute COVID-19 in ARD patients revealed that age, sex, clinical severity of COVID-19, reinfection, and autoimmune diseases were not associated with this condition (p > 0.05). The clinical manifestations of post-acute COVID-19 were similar in both groups (p > 0.05), with fatigue and memory loss being the most frequent manifestations.
We provide novel data demonstrating that immune/inflammatory ARD disturbances after third dose vaccination do not seem to be a major determinant of post-acute COVID-19 since its pattern is very similar to that of the general population. Clinical Trials platform (NCT04754698).
关于自身免疫性风湿病（ARD）患者急性新冠后(post-acute COVID-19)的数据很少，且主要聚焦于单一疾病，对该疾病的定义和疫苗接种时间存在差异。本研究旨在使用既定的诊断标准评估接种疫苗的 ARD 患者急性新冠后(post-acute COVID-19)的频率和模式。
回顾性评估了 108 名 ARD 患者和 32 名非 ARD 对照者的前瞻性队列，这些患者在第三剂科兴疫苗接种后，经逆转录酶聚合酶链反应（RT-PCR）/抗原检测被诊断为 SARS-CoV-2 感染。根据既定的国际标准，登记急性新冠后(post-acute COVID-19)（≥ 4 周且 SARS-CoV-2 症状持续> 12 周）病例。
ARD 患者和非 ARD 对照者在年龄和性别上相匹配，急性新冠后(post-acute COVID-19)≥ 4 周（58.3% vs. 53.1%，p=0.6854）和≥ 12 周（39.8% vs. 46.9%，p=0.5419）的频率较高且相似。关于急性新冠后(post-acute COVID-19)≥ 4 周，ARD 和非 ARD 对照组≥ 3 种症状的频率相似（54% vs. 41.2%，p=0.7886），急性新冠后(post-acute COVID-19)≥ 12 周时也是如此（68.3% vs. 88.2%，p=0.1322）。对 ARD 患者≥ 4 周急性新冠后(post-acute COVID-19)的危险因素进一步分析表明，年龄、性别、COVID-19 临床严重程度、再感染和自身免疫性疾病与该疾病无关（p>0.05）。两组的急性新冠后(post-acute COVID-19)临床表现相似（p>0.05），疲劳和记忆力减退是最常见的表现。
我们提供了新的数据，表明第三剂疫苗接种后免疫/炎症性 ARD 紊乱似乎不是急性新冠后(post-acute COVID-19)的主要决定因素，因为其模式与普通人群非常相似。临床试验平台（NCT04754698）。
