Pan Wei, Li Yun, Luo Junjia, Li Chun, Ye Hua, Li Xue, Jia Yuan
Department of Rheumatology and Immunology, Peking University People' s Hospital, Beijing 100044, China.
Department of Clinical Laboratory, 923 Hospital of the Chinese People' s Liberation Army Joint Logistic Support Force, Nanning 530021, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2024 Dec 18;56(6):1041-1046. doi: 10.19723/j.issn.1671-167X.2024.06.015.
To comprehensively understand the COVID-19 vaccination and infection status among patients with systemic sclerosis (SSc).
We conducted a retrospective analysis of patients diagnosed with SSc who were hospitalized in the Rheumatology and Immunology Department of Peking University People' s Hospital from January 2016 to March 2023. We collected detailed clinical cha-racteristics, vaccination status, and infection details through a systematic review of medical records and telephone follow-ups with the SSc patients.
Out of 236 identified patients, 99 SSc patients participated in the follow-up. This cohort included 41 patients with limited SSc, 28 with diffuse SSc, and 30 with SSc overlap syndromes. Treatments varied, with glucocorticoids administered to 57.58% of patients, immunosuppressants to 56.57%, biologic agents to 7.07%, and small molecule targeted therapies to 6.06%. Notably, 49 patients had received the COVID-19 vaccine. Between November 2022 and March 2023, a total of 81 patients contracted COVID-19. The infection rate among those who received three doses or more (19/29, 65.5%) was significantly lower compared with unvaccinated patients (45/50, 90.0%, =0.007). Fourteen of these patients required hospitalization due to COVID-19. Furthermore, 26 patients reported exacerbation of SSc symptoms post-infection, which included severe manifestations, such as Raynaud phenomenon, skin lesions, fingertip ulcers, pulmonary hypertension, and interstitial lung disease. Compared with healthy cohabitants, the SSc patients exhibited more severe symptoms following COVID-19, including fever (36.71%) and fatigue (35.44%). Multivariate regression analysis identified subcutaneous calcinosis (=7.713, 95%: 1.142-45.051) and positivity for anti-centromere antibodies (=9.210, 95%: 1.211-70.028) as independent risk factors for hospitalization due to COVID-19.
Vaccination is both effective and safe in preventing COVID-19 among SSc patients. Additionally, it underscores that these patients experience exacerbation of their underlying disease and more severe COVID-19 symptoms compared with individuals without underlying conditions. Thus, proactive prevention, continuous monitoring, and early treatment of COVID-19 are of significant importance for the health and well-being of SSc patients. Timely interventions can help mitigate the impact of infections and improve overall patient outcomes.
全面了解系统性硬化症（SSc）患者的新冠病毒疫苗接种及感染情况。
我们对2016年1月至2023年3月期间在北京大学人民医院风湿免疫科住院的确诊为SSc的患者进行了回顾性分析。通过系统查阅病历并对SSc患者进行电话随访，收集详细的临床特征、疫苗接种状况及感染详情。
在236例已识别的患者中，99例SSc患者参与了随访。该队列包括41例局限性SSc患者、28例弥漫性SSc患者和30例SSc重叠综合征患者。治疗方式多样，57.58%的患者使用糖皮质激素，56.57%使用免疫抑制剂，7.07%使用生物制剂，6.06%使用小分子靶向疗法。值得注意的是，49例患者接种了新冠病毒疫苗。在2022年11月至2023年3月期间，共有81例患者感染了新冠病毒。接种三剂及以上疫苗的患者感染率（19/29，65.5%）显著低于未接种疫苗的患者（45/50，90.0%，P = 0.007）。其中14例患者因新冠病毒感染需要住院治疗。此外，26例患者报告感染后SSc症状加重，包括雷诺现象、皮肤病变、指尖溃疡、肺动脉高压和间质性肺病等严重表现。与健康同居者相比，SSc患者感染新冠病毒后症状更严重，包括发热（36.71%）和疲劳（35.44%）。多因素回归分析确定皮下钙质沉着（P = 7.713，95%置信区间：1.142 - 45.051）和抗着丝点抗体阳性（P = 9.210，95%置信区间：1.211 - 70.028）是因新冠病毒感染住院的独立危险因素。
接种疫苗在预防SSc患者感染新冠病毒方面既有效又安全。此外，这凸显出与无基础疾病的个体相比，这些患者潜在疾病会加重，且感染新冠病毒后的症状更严重。因此，对SSc患者而言，积极预防、持续监测和早期治疗新冠病毒感染对其健康和福祉至关重要。及时干预有助于减轻感染的影响并改善患者总体预后。
