Diaz-Menindez Maximiliano, Sullivan Megan M, Wang Benjamin, Majithia Vikas, Abril Andy, Butendieck Ronald R, Ball Colleen T, Berianu Florentina
Mayo Clinic, Scottsdale, Arizona.
Mayo Clinic, Jacksonville, Florida.
Arthritis Care Res (Hoboken). 2024 Jan;76(1):98-104. doi: 10.1002/acr.25236. Epub 2023 Nov 3.
New-onset and relapsed dermatomyositis (DM) has been reported following SARS-CoV-2 infection or COVID-19 vaccination. This study aims to show the characteristics of a DM cohort after COVID-19 infection and vaccination.
A retrospective review was performed on patients treated for DM between March 1, 2020, and October 31, 2022. Charts were evaluated for the presence of new-onset DM or relapse of preexisting DM following either SARS-CoV-2 infection or COVID-19 vaccination. Data on symptom onset, timing of vaccination, type of vaccination, and disease characteristics were collected.
Ninety-eight patients treated for DM at our institution in the Division of Rheumatology were included. In total, 12 of 98 patients (12.2%) experienced DM symptoms (either incident or relapse) following either infection or vaccination. Of the 12 patients who developed incident disease or relapse, 7 (58.3%) developed postinfection symptoms, and 8 (66.7%) developed symptoms after vaccination (3 patients had symptoms following both infection and vaccination). The mean onset of symptoms following COVID-19 infection was 3.2 days (median 0.5 days), and mean onset following COVID-19 vaccination was 5.75 days (median 3.5 days). Nine of 12 patients (75%) had a positive myositis-specific antibody, and the remaining 3 (25%) had myositis-associated antibodies. There was no predominant vaccine associated with the development of postvaccination DM symptoms.
This retrospective review revealed a strong temporal relationship between DM symptoms and COVID-19 infection or vaccination in 12.2% of all patients with DM evaluated in our clinic during the pandemic. Additional studies are required to understand the possible pathophysiology behind this association.
已有报告称，新型冠状病毒2（SARS-CoV-2）感染或新型冠状病毒肺炎（COVID-19）疫苗接种后会出现新发和复发的皮肌炎（DM）。本研究旨在展现COVID-19感染和疫苗接种后DM队列的特征。
对2020年3月1日至2022年10月31日期间接受DM治疗的患者进行回顾性研究。评估病历，以确定SARS-CoV-2感染或COVID-19疫苗接种后是否存在新发DM或既往DM复发。收集症状发作、疫苗接种时间、疫苗类型和疾病特征的数据。
纳入了我院风湿病科接受DM治疗的98例患者。在98例患者中，共有12例（12.2%）在感染或接种疫苗后出现DM症状（新发或复发）。在出现新发疾病或复发的12例患者中，7例（58.3%）出现感染后症状，8例（66.7%）在接种疫苗后出现症状（3例在感染和接种疫苗后均出现症状）。COVID-19感染后症状的平均发作时间为3.2天（中位数为0.5天），COVID-19疫苗接种后症状的平均发作时间为5.75天（中位数为3.5天）。12例患者中有9例（75%）肌炎特异性抗体呈阳性，其余3例（25%）有肌炎相关抗体。没有哪种疫苗与接种后DM症状的发生有显著关联。
这项回顾性研究显示，在大流行期间我们诊所评估的所有DM患者中，12.2%的患者DM症状与COVID-19感染或疫苗接种之间存在密切的时间关系。需要进一步的研究来了解这种关联背后可能的病理生理学机制。
