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Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase

INTRODUCTION: The impact of COVID-19 pandemic represents a serious challenge for ‘frail’ patients' populations with inflammatory autoimmune systemic diseases such as systemic sclerosis (SSc). We investigated the prevalence and severity of COVID-19, as well the effects of COVID-19 vaccination ca...

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Autores principales: Ferri, Clodoveo, Raimondo, Vincenzo, Giuggioli, Dilia, Gragnani, Laura, Lorini, Serena, Dagna, Lorenzo, Bosello, Silvia Laura, Foti, Rosario, Riccieri, Valeria, Guiducci, Serena, Cuomo, Giovanna, Tavoni, Antonio, De Angelis, Rossella, Cacciapaglia, Fabio, Zanatta, Elisabetta, Cozzi, Franco, Murdaca, Giuseppe, Cavazzana, Ilaria, Romeo, Nicoletta, Codullo, Veronica, Pellegrini, Roberta, Varcasia, Giuseppe, De Santis, Maria, Selmi, Carlo, Abignano, Giuseppina, Caminiti, Maurizio, L'Andolina, Massimo, Olivo, Domenico, Lubrano, Ennio, Spinella, Amelia, Lumetti, Federica, De Luca, Giacomo, Ruscitti, Piero, Urraro, Teresa, Visentini, Marcella, Bellando-Randone, Silvia, Visalli, Elisa, Testa, Davide, Sciascia, Gabriella, Masini, Francesco, Pellegrino, Greta, Saccon, Francesca, Balestri, Eugenia, Elia, Giusy, Ferrari, Silvia Martina, Tonutti, Antonio, Dall’Ara, Francesca, Pagano Mariano, Giuseppa, Pettiti, Giorgio, Zanframundo, Giovanni, Brittelli, Raffaele, Aiello, Vincenzo, Dal Bosco, Ylenia, Foti, Roberta, Di Cola, Ilenia, Scorpiniti, Daniela, Fusaro, Enrico, Ferrari, Tommaso, Gigliotti, Pietro, Campochiaro, Corrado, Francioso, Francesca, Iandoli, Carlo, Caira, Virginia, Zignego, Anna Linda, D'Angelo, Salvatore, Franceschini, Franco, Matucci-Cerinic, Marco, Giacomelli, Roberto, Doria, Andrea, Santini, Stefano Angelo, Fallahi, Poupak, Iannone, Florenzo, Antonelli, Alessandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580042/
https://www.ncbi.nlm.nih.gov/pubmed/37854035
http://dx.doi.org/10.1016/j.jtauto.2023.100212
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author Ferri, Clodoveo
Raimondo, Vincenzo
Giuggioli, Dilia
Gragnani, Laura
Lorini, Serena
Dagna, Lorenzo
Bosello, Silvia Laura
Foti, Rosario
Riccieri, Valeria
Guiducci, Serena
Cuomo, Giovanna
Tavoni, Antonio
De Angelis, Rossella
Cacciapaglia, Fabio
Zanatta, Elisabetta
Cozzi, Franco
Murdaca, Giuseppe
Cavazzana, Ilaria
Romeo, Nicoletta
Codullo, Veronica
Pellegrini, Roberta
Varcasia, Giuseppe
De Santis, Maria
Selmi, Carlo
Abignano, Giuseppina
Caminiti, Maurizio
L'Andolina, Massimo
Olivo, Domenico
Lubrano, Ennio
Spinella, Amelia
Lumetti, Federica
De Luca, Giacomo
Ruscitti, Piero
Urraro, Teresa
Visentini, Marcella
Bellando-Randone, Silvia
Visalli, Elisa
Testa, Davide
Sciascia, Gabriella
Masini, Francesco
Pellegrino, Greta
Saccon, Francesca
Balestri, Eugenia
Elia, Giusy
Ferrari, Silvia Martina
Tonutti, Antonio
Dall’Ara, Francesca
Pagano Mariano, Giuseppa
Pettiti, Giorgio
Zanframundo, Giovanni
Brittelli, Raffaele
Aiello, Vincenzo
Dal Bosco, Ylenia
Foti, Roberta
Di Cola, Ilenia
Scorpiniti, Daniela
Fusaro, Enrico
Ferrari, Tommaso
Gigliotti, Pietro
Campochiaro, Corrado
Francioso, Francesca
Iandoli, Carlo
Caira, Virginia
Zignego, Anna Linda
D'Angelo, Salvatore
Franceschini, Franco
Matucci-Cerinic, Marco
Giacomelli, Roberto
Doria, Andrea
Santini, Stefano Angelo
Fallahi, Poupak
Iannone, Florenzo
Antonelli, Alessandro
author_facet Ferri, Clodoveo
Raimondo, Vincenzo
Giuggioli, Dilia
Gragnani, Laura
Lorini, Serena
Dagna, Lorenzo
Bosello, Silvia Laura
Foti, Rosario
Riccieri, Valeria
Guiducci, Serena
Cuomo, Giovanna
Tavoni, Antonio
De Angelis, Rossella
Cacciapaglia, Fabio
Zanatta, Elisabetta
Cozzi, Franco
Murdaca, Giuseppe
Cavazzana, Ilaria
Romeo, Nicoletta
Codullo, Veronica
Pellegrini, Roberta
Varcasia, Giuseppe
De Santis, Maria
Selmi, Carlo
Abignano, Giuseppina
Caminiti, Maurizio
L'Andolina, Massimo
Olivo, Domenico
Lubrano, Ennio
Spinella, Amelia
Lumetti, Federica
De Luca, Giacomo
Ruscitti, Piero
Urraro, Teresa
Visentini, Marcella
Bellando-Randone, Silvia
Visalli, Elisa
Testa, Davide
Sciascia, Gabriella
Masini, Francesco
Pellegrino, Greta
Saccon, Francesca
Balestri, Eugenia
Elia, Giusy
Ferrari, Silvia Martina
Tonutti, Antonio
Dall’Ara, Francesca
Pagano Mariano, Giuseppa
Pettiti, Giorgio
Zanframundo, Giovanni
Brittelli, Raffaele
Aiello, Vincenzo
Dal Bosco, Ylenia
Foti, Roberta
Di Cola, Ilenia
Scorpiniti, Daniela
Fusaro, Enrico
Ferrari, Tommaso
Gigliotti, Pietro
Campochiaro, Corrado
Francioso, Francesca
Iandoli, Carlo
Caira, Virginia
Zignego, Anna Linda
D'Angelo, Salvatore
Franceschini, Franco
Matucci-Cerinic, Marco
Giacomelli, Roberto
Doria, Andrea
Santini, Stefano Angelo
Fallahi, Poupak
Iannone, Florenzo
Antonelli, Alessandro
author_sort Ferri, Clodoveo
collection PubMed
description INTRODUCTION: The impact of COVID-19 pandemic represents a serious challenge for ‘frail’ patients' populations with inflammatory autoimmune systemic diseases such as systemic sclerosis (SSc). We investigated the prevalence and severity of COVID-19, as well the effects of COVID-19 vaccination campaign in a large series of SSc patients followed for the entire period (first 38 months) of pandemic. PATIENTS AND METHOD: This prospective survey study included 1755 unselected SSc patients (186 M, 1,569F; mean age 58.7 ± 13.4SD years, mean disease duration 8.8 ± 7.3SD years) recruited in part by telephone survey at 37 referral centers from February 2020 to April 2023. The following parameters were carefully evaluated: i. demographic, clinical, serological, and therapeutical features; ii. prevalence and severity of COVID-19; and iii. safety, immunogenicity, and efficacy of COVID-19 vaccines. RESULTS: The prevalence of COVID-19 recorded during the whole pandemic was significantly higher compared to Italian general population (47.3 % vs 43.3 %, p < 0.000), as well the COVID-19-related mortality (1.91 % vs 0.72 %, p < 0.001). As regards the putative prognostic factors of worse outcome, COVID-19 positive patients with SSc-related interstitial lung involvement showed significantly higher percentage of COVID-19-related hospitalization compared to those without (5.85 % vs 1.73 %; p < 0.0001), as well as of mortality rate (2.01 % vs 0.4 %; p = 0.002). Over half of patients (56.3 %) received the first two plus one booster dose of vaccine; while a fourth dose was administered to 35.6 %, and only few of them (1.99 %) had five or more doses of vaccine. Of note, an impaired seroconversion was recorded in 25.6 % of individuals after the first 2 doses of vaccine, and in 8.4 % of patients also after the booster dose. Furthermore, the absence of T-cell immunoreactivity was observed in 3/7 patients tested by QuantiFERON® SARSCoV-2 Starter Set (Qiagen). The efficacy of vaccines, evaluated by comparing the COVID-19-related death rate recorded during pre- and post-vaccination pandemic periods, revealed a quite stable outcome in SSc patients (death rate from 2.54 % to 1.76 %; p = ns), despite the significant drop of mortality observed in the Italian general population (from 2.95 % to 0.29 %; p < 0.0001). CONCLUSIONS: An increased COVID-19 prevalence and mortality rate was recorded in SSc patients; moreover, the efficacy of vaccines in term of improved outcomes was less evident in SSc compared to Italian general population. This discrepancy might be explained by concomitant adverse prognostic factors: increased rate of non-responders to vaccine in SSc series, low percentage of individuals with four or more doses of vaccine, ongoing immunomodulating treatments, disease-related interstitial lung disease, and/or reduced preventive measures in the second half of pandemic. A careful monitoring of response to COVID-19 vaccines together with adequate preventive/therapeutical strategies are highly recommendable in the near course of pandemic in this frail patients’ population.
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spelling pubmed-105800422023-10-18 Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase Ferri, Clodoveo Raimondo, Vincenzo Giuggioli, Dilia Gragnani, Laura Lorini, Serena Dagna, Lorenzo Bosello, Silvia Laura Foti, Rosario Riccieri, Valeria Guiducci, Serena Cuomo, Giovanna Tavoni, Antonio De Angelis, Rossella Cacciapaglia, Fabio Zanatta, Elisabetta Cozzi, Franco Murdaca, Giuseppe Cavazzana, Ilaria Romeo, Nicoletta Codullo, Veronica Pellegrini, Roberta Varcasia, Giuseppe De Santis, Maria Selmi, Carlo Abignano, Giuseppina Caminiti, Maurizio L'Andolina, Massimo Olivo, Domenico Lubrano, Ennio Spinella, Amelia Lumetti, Federica De Luca, Giacomo Ruscitti, Piero Urraro, Teresa Visentini, Marcella Bellando-Randone, Silvia Visalli, Elisa Testa, Davide Sciascia, Gabriella Masini, Francesco Pellegrino, Greta Saccon, Francesca Balestri, Eugenia Elia, Giusy Ferrari, Silvia Martina Tonutti, Antonio Dall’Ara, Francesca Pagano Mariano, Giuseppa Pettiti, Giorgio Zanframundo, Giovanni Brittelli, Raffaele Aiello, Vincenzo Dal Bosco, Ylenia Foti, Roberta Di Cola, Ilenia Scorpiniti, Daniela Fusaro, Enrico Ferrari, Tommaso Gigliotti, Pietro Campochiaro, Corrado Francioso, Francesca Iandoli, Carlo Caira, Virginia Zignego, Anna Linda D'Angelo, Salvatore Franceschini, Franco Matucci-Cerinic, Marco Giacomelli, Roberto Doria, Andrea Santini, Stefano Angelo Fallahi, Poupak Iannone, Florenzo Antonelli, Alessandro J Transl Autoimmun Research paper INTRODUCTION: The impact of COVID-19 pandemic represents a serious challenge for ‘frail’ patients' populations with inflammatory autoimmune systemic diseases such as systemic sclerosis (SSc). We investigated the prevalence and severity of COVID-19, as well the effects of COVID-19 vaccination campaign in a large series of SSc patients followed for the entire period (first 38 months) of pandemic. PATIENTS AND METHOD: This prospective survey study included 1755 unselected SSc patients (186 M, 1,569F; mean age 58.7 ± 13.4SD years, mean disease duration 8.8 ± 7.3SD years) recruited in part by telephone survey at 37 referral centers from February 2020 to April 2023. The following parameters were carefully evaluated: i. demographic, clinical, serological, and therapeutical features; ii. prevalence and severity of COVID-19; and iii. safety, immunogenicity, and efficacy of COVID-19 vaccines. RESULTS: The prevalence of COVID-19 recorded during the whole pandemic was significantly higher compared to Italian general population (47.3 % vs 43.3 %, p < 0.000), as well the COVID-19-related mortality (1.91 % vs 0.72 %, p < 0.001). As regards the putative prognostic factors of worse outcome, COVID-19 positive patients with SSc-related interstitial lung involvement showed significantly higher percentage of COVID-19-related hospitalization compared to those without (5.85 % vs 1.73 %; p < 0.0001), as well as of mortality rate (2.01 % vs 0.4 %; p = 0.002). Over half of patients (56.3 %) received the first two plus one booster dose of vaccine; while a fourth dose was administered to 35.6 %, and only few of them (1.99 %) had five or more doses of vaccine. Of note, an impaired seroconversion was recorded in 25.6 % of individuals after the first 2 doses of vaccine, and in 8.4 % of patients also after the booster dose. Furthermore, the absence of T-cell immunoreactivity was observed in 3/7 patients tested by QuantiFERON® SARSCoV-2 Starter Set (Qiagen). The efficacy of vaccines, evaluated by comparing the COVID-19-related death rate recorded during pre- and post-vaccination pandemic periods, revealed a quite stable outcome in SSc patients (death rate from 2.54 % to 1.76 %; p = ns), despite the significant drop of mortality observed in the Italian general population (from 2.95 % to 0.29 %; p < 0.0001). CONCLUSIONS: An increased COVID-19 prevalence and mortality rate was recorded in SSc patients; moreover, the efficacy of vaccines in term of improved outcomes was less evident in SSc compared to Italian general population. This discrepancy might be explained by concomitant adverse prognostic factors: increased rate of non-responders to vaccine in SSc series, low percentage of individuals with four or more doses of vaccine, ongoing immunomodulating treatments, disease-related interstitial lung disease, and/or reduced preventive measures in the second half of pandemic. A careful monitoring of response to COVID-19 vaccines together with adequate preventive/therapeutical strategies are highly recommendable in the near course of pandemic in this frail patients’ population. Elsevier 2023-10-09 /pmc/articles/PMC10580042/ /pubmed/37854035 http://dx.doi.org/10.1016/j.jtauto.2023.100212 Text en © 2023 Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research paper
Ferri, Clodoveo
Raimondo, Vincenzo
Giuggioli, Dilia
Gragnani, Laura
Lorini, Serena
Dagna, Lorenzo
Bosello, Silvia Laura
Foti, Rosario
Riccieri, Valeria
Guiducci, Serena
Cuomo, Giovanna
Tavoni, Antonio
De Angelis, Rossella
Cacciapaglia, Fabio
Zanatta, Elisabetta
Cozzi, Franco
Murdaca, Giuseppe
Cavazzana, Ilaria
Romeo, Nicoletta
Codullo, Veronica
Pellegrini, Roberta
Varcasia, Giuseppe
De Santis, Maria
Selmi, Carlo
Abignano, Giuseppina
Caminiti, Maurizio
L'Andolina, Massimo
Olivo, Domenico
Lubrano, Ennio
Spinella, Amelia
Lumetti, Federica
De Luca, Giacomo
Ruscitti, Piero
Urraro, Teresa
Visentini, Marcella
Bellando-Randone, Silvia
Visalli, Elisa
Testa, Davide
Sciascia, Gabriella
Masini, Francesco
Pellegrino, Greta
Saccon, Francesca
Balestri, Eugenia
Elia, Giusy
Ferrari, Silvia Martina
Tonutti, Antonio
Dall’Ara, Francesca
Pagano Mariano, Giuseppa
Pettiti, Giorgio
Zanframundo, Giovanni
Brittelli, Raffaele
Aiello, Vincenzo
Dal Bosco, Ylenia
Foti, Roberta
Di Cola, Ilenia
Scorpiniti, Daniela
Fusaro, Enrico
Ferrari, Tommaso
Gigliotti, Pietro
Campochiaro, Corrado
Francioso, Francesca
Iandoli, Carlo
Caira, Virginia
Zignego, Anna Linda
D'Angelo, Salvatore
Franceschini, Franco
Matucci-Cerinic, Marco
Giacomelli, Roberto
Doria, Andrea
Santini, Stefano Angelo
Fallahi, Poupak
Iannone, Florenzo
Antonelli, Alessandro
Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
title Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
title_full Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
title_fullStr Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
title_full_unstemmed Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
title_short Impact of COVID-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. Possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
title_sort impact of covid-19 and vaccination campaign on 1,755 systemic sclerosis patients during first three years of pandemic. possible risks for individuals with impaired immunoreactivity to vaccine, ongoing immunomodulating treatments, and disease-related lung involvement during the next pandemic phase
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580042/
https://www.ncbi.nlm.nih.gov/pubmed/37854035
http://dx.doi.org/10.1016/j.jtauto.2023.100212
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AT sciasciagabriella impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT masinifrancesco impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT pellegrinogreta impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT sacconfrancesca impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT balestrieugenia impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT eliagiusy impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT ferrarisilviamartina impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT tonuttiantonio impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT dallarafrancesca impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT paganomarianogiuseppa impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT pettitigiorgio impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT zanframundogiovanni impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT brittelliraffaele impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT aiellovincenzo impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT dalboscoylenia impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT fotiroberta impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT dicolailenia impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT scorpinitidaniela impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT fusaroenrico impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT ferraritommaso impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT gigliottipietro impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT campochiarocorrado impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT franciosofrancesca impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT iandolicarlo impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT cairavirginia impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT zignegoannalinda impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT dangelosalvatore impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT franceschinifranco impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT matuccicerinicmarco impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT giacomelliroberto impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT doriaandrea impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT santinistefanoangelo impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT fallahipoupak impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT iannoneflorenzo impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT antonellialessandro impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase
AT impactofcovid19andvaccinationcampaignon1755systemicsclerosispatientsduringfirstthreeyearsofpandemicpossiblerisksforindividualswithimpairedimmunoreactivitytovaccineongoingimmunomodulatingtreatmentsanddiseaserelatedlunginvolvementduringthenextpandemicphase