Center for Evidence-Based Medicine and Clinical Research, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
Department of Medical, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
Ann Med. 2024 Dec;56(1):2392882. doi: 10.1080/07853890.2024.2392882. Epub 2024 Aug 19.
Systemic lupus erythematosus (SLE), an extensive autoimmune disorder, compromises viral resistance and alters immune responses post respiratory virus vaccines. This study aims to assess immune response levels and safety in SLE patients following respiratory virus vaccines.
Extensive searches, until 1 March 2024, were conducted using PubMed, EMBASE, and Cochrane Library. Outcomes, encompassing seroconversion rate (SCR), antibody and IgG titers, neutralizing antibodies, anti-spike antibodies, anti-receptor binding domain (RBD) IgG, and adverse events, were appraised.
Sixteen articles, comprising 25 observational studies, were included. SLE patients exhibited lower SCR (OR = 0.42, 95%CI: 0.26 to 0.69), antibody titers (SMD=-2.84, 95%CI: -3.36 to -1.61), and neutralizing antibodies (OR = 0.27, 95%CI: 0.13 to 0.56) compared to the healthy population post respiratory virus vaccines. Notably, differences were statistically insignificant for anti-RBD IgG (OR = 1.75, 95%CI: 0.10 to 29.42), IgG titers (SMD=-2.54, 95%CI: -5.57 to -0.49), anti-spike antibodies (OR = 0.35, 95%CI: 0.08 to 1.53), injection site discomfort (OR = 1.03, 95%CI: 0.52 to 2.06), fatigue (OR = 1.23, 95%CI: 0.74 to 2.03), fever (OR = 1.02, 95%CI: 0.64 to 1.63), localized reactions (OR = 0.69, 95%CI: 0.37 to 1.30), systemic reactions (OR = 1.00, 95%CI: 0.59 to 1.69), allergic reactions (OR = 5.11, 95%CI: 0.24 to 107.10), self-reported vaccination-related adverse events (OR = 1.61, 95%CI: 0.56 to 4.63), and disease flares after vaccination (OR = 1.00, 95%CI: 0.14 to 7.28).
Despite the reduced immune response and host protection in SLE patients post-Corona Virus Disease 2019 (COVID-19) and influenza vaccines compared to the healthy population, safety profiles are comparable. Therefore, it is recommended that SLE patients receive COVID-19 and influenza viral vaccines to fortify their resistance.
系统性红斑狼疮（SLE）是一种广泛的自身免疫性疾病，会影响病毒抵抗力并改变呼吸道病毒疫苗接种后的免疫反应。本研究旨在评估 SLE 患者接种呼吸道病毒疫苗后的免疫反应水平和安全性。
通过 PubMed、EMBASE 和 Cochrane Library 进行广泛检索，检索时间截至 2024 年 3 月 1 日。评估指标包括血清转化率（SCR）、抗体和 IgG 滴度、中和抗体、刺突抗体、抗受体结合域（RBD）IgG 以及不良事件。
共纳入 16 篇文章，包括 25 项观察性研究。与健康人群相比，SLE 患者接种呼吸道病毒疫苗后 SCR（OR=0.42，95%CI：0.26 至 0.69）、抗体滴度（SMD=-2.84，95%CI：-3.36 至 -1.61）和中和抗体（OR=0.27，95%CI：0.13 至 0.56）均较低。值得注意的是，抗-RBD IgG（OR=1.75，95%CI：0.10 至 29.42）、IgG 滴度（SMD=-2.54，95%CI：-5.57 至 -0.49）、刺突抗体（OR=0.35，95%CI：0.08 至 1.53）、注射部位不适（OR=1.03，95%CI：0.52 至 2.06）、疲劳（OR=1.23，95%CI：0.74 至 2.03）、发热（OR=1.02，95%CI：0.64 至 1.63）、局部反应（OR=0.69，95%CI：0.37 至 1.30）、全身反应（OR=1.00，95%CI：0.59 至 1.69）、过敏反应（OR=5.11，95%CI：0.24 至 107.10）、自我报告的与疫苗接种相关的不良事件（OR=1.61，95%CI：0.56 至 4.63）和接种疫苗后疾病发作（OR=1.00，95%CI：0.14 至 7.28）的发生率与健康人群相比无显著差异。
尽管与健康人群相比，SLE 患者接种 COVID-19 和流感疫苗后的免疫反应和宿主保护作用降低，但安全性相当。因此，建议 SLE 患者接种 COVID-19 和流感病毒疫苗以增强其抵抗力。
