Internal Medicine and Nephrology Division, Department of Clinical Medicine, Life, Health and Environmental Sciences, University of L'Aquila and San Salvatore Hospital, Piazzale Salvatore Tommasi 1, 67100, L'Aquila, Italy.
NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK.
Rheumatol Int. 2024 Sep;44(9):1725-1731. doi: 10.1007/s00296-024-05654-w. Epub 2024 Jul 13.
Notwithstanding the wealth of literature on COVID-19, studies focusing on young adults with autoimmune diseases (AD) are lacking. To determine early (within 7 days) and late (after 7 days) anti-SARS-CoV-2 vaccine-related adverse events (AEs), post-vaccine disease flares, COVID-19 severity and breakthrough infections (B-INFs) in young people with rheumatic diseases (RMDs) and non-rheumatic autoimmune diseases (nr-ADs) compared to healthy controls (HC). Data were captured through the international COVID-19 vaccination in autoimmune diseases (COVAD) 1 and 2 questionnaires. Of 20,685 complete responses, we identified 6010 from patients aged 18-35 years (1692 RMD, 400 nrADs, 3918 HC) who received up to 4 vaccine doses. BNT162b2 was the most frequently administered vaccine and prior to vaccination, 7% of people with nrAD were taking immunosuppressants (IS) versus 80% in RMDs. Early mild AEs were more frequent in RMDs (93%) and nr-ADs (92%) compared to HC (85%). The frequency of late mild AEs was < 20% in all groups. Severe AEs were rare. SARS-CoV-2 infection rates were similar across all groups, however, RMD patients reported a single episode of infection more frequently than nrADs and HC, while nrADs reported multiple infections more frequently than RMD. Self-reported disease flares were reported by 10% or RMD and 7% of nrAD patients. Our study reinforces the safety of anti-SARS-CoV-2 vaccine also in young people with ADs, but it also highlights that among young individuals the number and clinical picture of SARS-CoV-2 infections is affected more by the type of AD rather than by coexisting IS therapy.
尽管有大量关于 COVID-19 的文献，但缺乏针对年轻的自身免疫性疾病（AD）患者的研究。为了确定患有风湿性疾病（RMD）和非风湿性自身免疫性疾病（nr-AD）的年轻人与健康对照组（HC）相比，早期（7 天内）和晚期（7 天后）抗 SARS-CoV-2 疫苗相关不良事件（AEs）、疫苗后疾病发作、COVID-19 严重程度和突破性感染（B-INFs）的情况。数据通过国际自身免疫性疾病 COVID-19 疫苗接种（COVAD）1 和 2 问卷收集。在 20685 份完整回复中，我们确定了年龄在 18-35 岁的 6010 名患者（1692 名 RMD、400 名 nrAD、3918 名 HC）接受了最多 4 剂疫苗。BNT162b2 是最常使用的疫苗，在接种疫苗之前，7%的 nrAD 患者正在服用免疫抑制剂（IS），而 RMD 患者中有 80%在服用。RMD（93%）和 nr-AD（92%）的早期轻度 AEs 比 HC（85%）更常见。所有组的晚期轻度 AEs 频率均<20%。严重 AEs 罕见。所有组的 SARS-CoV-2 感染率相似，但 RMD 患者比 nrAD 和 HC 更频繁地报告单次感染，而 nrAD 比 RMD 更频繁地报告多次感染。10%或 RMD 和 7%的 nrAD 患者报告了自身疾病发作。我们的研究再次证实了抗 SARS-CoV-2 疫苗在 AD 患者中也很安全，但也强调了在年轻人中，SARS-CoV-2 感染的数量和临床情况更多地受到 AD 类型的影响，而不是 IS 治疗的影响。
