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Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination
BACKGROUND: Paediatric patients with autoimmune rheumatic diseases (pARD) are often immunocompromised because of the disease and/or the therapy they receive. At the beginning of COVID-19 pandemic there was a great concern about the possibility of severe SARS-CoV-2 infection in these patients. The be...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10197037/ https://www.ncbi.nlm.nih.gov/pubmed/37208721 http://dx.doi.org/10.1186/s12969-023-00829-4 |
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author | Šinkovec Savšek, Tjaša Zajc Avramovič, Mojca Avčin, Tadej Korva, Miša Avšič Županc, Tatjana Toplak, Nataša |
author_facet | Šinkovec Savšek, Tjaša Zajc Avramovič, Mojca Avčin, Tadej Korva, Miša Avšič Županc, Tatjana Toplak, Nataša |
author_sort | Šinkovec Savšek, Tjaša |
collection | PubMed |
description | BACKGROUND: Paediatric patients with autoimmune rheumatic diseases (pARD) are often immunocompromised because of the disease and/or the therapy they receive. At the beginning of COVID-19 pandemic there was a great concern about the possibility of severe SARS-CoV-2 infection in these patients. The best method of protection is vaccination, so as soon as vaccine was licenced, we aimed to vaccinate them. Data on disease relapse rate after COVID-19 infection and vaccination are scarce, but they play important role in everyday clinical decisions. METHODS: The aim of this study was to determine the relapse rate of autoimmune rheumatic disease (ARD) after COVID-19 infection and vaccination. Data on demographic, diagnosis, disease activity, therapy, clinical presentation of the infection and serology were collected from pARD who had COVID-19 and from pARD who were vaccinated against COVID-19, from March 2020 to April 2022. All vaccinated patients received two doses of the BNT162b2 BioNTech vaccine, on average, 3.7 (S.D.=1.4) weeks apart. Activity of the ARD was followed prospectively. Relapse was defined as a worsening of the ARD in a time frame of 8 weeks after infection or vaccination. For statistical analysis, Fisher’s exact test and Mann-Whitney U test were used. RESULTS: We collected data from 115 pARD, which we divided into two groups. We included 92 pARD after infection and 47 after vaccination, with 24 in both groups (they were infected before/after vaccination). In 92 pARD we registered 103 SARS-CoV-2 infections. Infection was asymptomatic in 14%, mild in 67% and moderate in 18%, 1% required hospitalization; 10% had a relapse of ARD after infection and 6% after vaccination. There was a trend towards higher disease relapse rate after infection compared to vaccination, but the difference was not statistically significant (p = 0.76). No statistically significant difference was detected in the relapse rate depending on the clinical presentation of the infection (p = 0.25) or the severity of the clinical presentation of COVID-19 between vaccinated and unvaccinated pARD (p = 0.31). CONCLUSIONS: There is a trend towards a higher relapse rate in pARD after infection compared to vaccination and connection between the severity of COVID-19 and vaccination status is plausible. Our results were, however, not statistically significant. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-023-00829-4. |
format | Online Article Text |
id | pubmed-10197037 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101970372023-05-20 Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination Šinkovec Savšek, Tjaša Zajc Avramovič, Mojca Avčin, Tadej Korva, Miša Avšič Županc, Tatjana Toplak, Nataša Pediatr Rheumatol Online J Research Article BACKGROUND: Paediatric patients with autoimmune rheumatic diseases (pARD) are often immunocompromised because of the disease and/or the therapy they receive. At the beginning of COVID-19 pandemic there was a great concern about the possibility of severe SARS-CoV-2 infection in these patients. The best method of protection is vaccination, so as soon as vaccine was licenced, we aimed to vaccinate them. Data on disease relapse rate after COVID-19 infection and vaccination are scarce, but they play important role in everyday clinical decisions. METHODS: The aim of this study was to determine the relapse rate of autoimmune rheumatic disease (ARD) after COVID-19 infection and vaccination. Data on demographic, diagnosis, disease activity, therapy, clinical presentation of the infection and serology were collected from pARD who had COVID-19 and from pARD who were vaccinated against COVID-19, from March 2020 to April 2022. All vaccinated patients received two doses of the BNT162b2 BioNTech vaccine, on average, 3.7 (S.D.=1.4) weeks apart. Activity of the ARD was followed prospectively. Relapse was defined as a worsening of the ARD in a time frame of 8 weeks after infection or vaccination. For statistical analysis, Fisher’s exact test and Mann-Whitney U test were used. RESULTS: We collected data from 115 pARD, which we divided into two groups. We included 92 pARD after infection and 47 after vaccination, with 24 in both groups (they were infected before/after vaccination). In 92 pARD we registered 103 SARS-CoV-2 infections. Infection was asymptomatic in 14%, mild in 67% and moderate in 18%, 1% required hospitalization; 10% had a relapse of ARD after infection and 6% after vaccination. There was a trend towards higher disease relapse rate after infection compared to vaccination, but the difference was not statistically significant (p = 0.76). No statistically significant difference was detected in the relapse rate depending on the clinical presentation of the infection (p = 0.25) or the severity of the clinical presentation of COVID-19 between vaccinated and unvaccinated pARD (p = 0.31). CONCLUSIONS: There is a trend towards a higher relapse rate in pARD after infection compared to vaccination and connection between the severity of COVID-19 and vaccination status is plausible. Our results were, however, not statistically significant. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-023-00829-4. BioMed Central 2023-05-19 /pmc/articles/PMC10197037/ /pubmed/37208721 http://dx.doi.org/10.1186/s12969-023-00829-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Šinkovec Savšek, Tjaša Zajc Avramovič, Mojca Avčin, Tadej Korva, Miša Avšič Županc, Tatjana Toplak, Nataša Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination |
title | Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination |
title_full | Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination |
title_fullStr | Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination |
title_full_unstemmed | Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination |
title_short | Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination |
title_sort | disease relapse rate in children with autoimmune rheumatic diseases after covid-19 infection and vaccination |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10197037/ https://www.ncbi.nlm.nih.gov/pubmed/37208721 http://dx.doi.org/10.1186/s12969-023-00829-4 |
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