青少年系统性红斑狼疮患者接种mRNA - COVID-19后疾病加重和COVID-19

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-05-01 Epub Date: 2025-03-29 DOI:10.1177/09612033251331244
Sutheera Thepveera, Sirirat Charuvanij, Maynart Sukharomana, Yanarin Thunsiribuddhichai, Kraisoon Lomjansook, Thanaporn Chaiyapak, Anirut Pattaragarn, Achra Sumboonnanoda, Nuntawan Piyaphanee
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Clinical characteristics, the safety of estrogens in lupus erythematosus national assessment-SLE disease activity index (SELENA-SLEDAI) flare index, and renal flare were evaluated and contrasted against pre-vaccination data. COVID-19 during follow-up were noted.ResultsSixty-nine vaccinated adoSLE patients, with the mean age of 15.8 ± 1.6 years and female predominant (92.8%), were included. Forty-six (66.7%) patients received a booster dose at 4-6 months after primary series. Compared between pre- and post- COVID-19 vaccination, year-on-year flare rates remained consistent [20 (29.0%) versus 24 (34.8%), <i>p</i> = .371]. Non-use of hydroxychloroquine (adjusted odds ratio [aOR] 18.83, 95% CI: 1.97, 179.60, <i>p</i> = .011) and a SELENA-SLEDAI score ≥8 within 12 months prior to vaccination (aOR 5.33, 95% CI: 1.38, 20.55, <i>p</i> = .015) were independent factors of disease flares. An increment in post-vaccine renal flare rate was observed [6 (8.7%) versus 14 (20.3%), <i>p</i> = .046]. 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引用次数: 0

摘要

目的评价青少年系统性红斑狼疮(SLE)患者接种2019冠状病毒病(COVID-19)疫苗后疾病发作及相关因素,以及2019冠状病毒病(COVID-19)的发生情况。此外,它还试图确定疫苗接种前后每年爆发率的差异。方法我们对12-18岁无COVID-19病史的青少年SLE (adoSLE)患者进行了一项为期12个月的前瞻性研究,这些患者接受了2剂BNT162b2 mRNA COVID-19疫苗。4-6个月后,根据疫苗的可得性和患者的接受程度,再注射一剂加强剂。对临床特征、雌激素治疗红斑狼疮的安全性、国家评估- sle疾病活动性指数(SELENA-SLEDAI)耀斑指数和肾耀斑进行评估,并与接种前的数据进行对比。在随访期间记录了COVID-19。结果纳入69例接种过疫苗的adoSLE患者,平均年龄15.8±1.6岁,女性占92.8%。46例(66.7%)患者在初始系列后4-6个月接受了加强剂量。与COVID-19疫苗接种前后相比,年爆发率保持一致[20例(29.0%)对24例(34.8%),p = 0.371]。未使用羟氯喹(校正优势比[aOR] 18.83, 95% CI: 1.97, 179.60, p = 0.011)和疫苗接种前12个月内selina - sledai评分≥8 (aOR 5.33, 95% CI: 1.38, 20.55, p = 0.015)是疾病发作的独立因素。观察到疫苗接种后肾耀斑率增加[6(8.7%)对14 (20.3%),p = 0.046]。14例adoSLE肾病患者中,13例(92.9%)患者既往有狼疮性肾炎,新发蛋白尿或蛋白尿增加(71.4%)是最常见的发现。34例(49.3%)患者在接种疫苗后一年内感染COVID-19,均表现为轻中度症状;在接受靴子治疗的46名患者中,有15名(32.6%)感染了新冠病毒。结论接种scovid -19疫苗可有效、安全地预防adoSLE患者的重症COVID-19,且不会增加SLE的年发作率。然而,建议密切监测肾脏耀斑,特别是有LN病史的患者。虽然接种疫苗的adoSLE患者感染了COVID-19,但他们的结果是有利的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disease exacerbation and COVID-19 following mRNA COVID-19 vaccination in adolescents with Systemic Lupus Erythematosus.

ObjectivesTo evaluate disease flares and associated factors, as well as the Coronavirus disease 2019 (COVID-19) among adolescents with systemic lupus erythematosus (SLE) after receiving COVID-19 vaccination. Additionally, it sought to determine any difference in year-on-year flare rates before and after vaccination.MethodsWe conducted a 12-month prospective study in adolescent SLE (adoSLE) patients aged 12-18 years who had no prior history of COVID-19 and received a 2-dose BNT162b2 mRNA COVID-19 vaccine. A booster dose was administered 4-6 months later, depending on vaccine availability and patient acceptance. Clinical characteristics, the safety of estrogens in lupus erythematosus national assessment-SLE disease activity index (SELENA-SLEDAI) flare index, and renal flare were evaluated and contrasted against pre-vaccination data. COVID-19 during follow-up were noted.ResultsSixty-nine vaccinated adoSLE patients, with the mean age of 15.8 ± 1.6 years and female predominant (92.8%), were included. Forty-six (66.7%) patients received a booster dose at 4-6 months after primary series. Compared between pre- and post- COVID-19 vaccination, year-on-year flare rates remained consistent [20 (29.0%) versus 24 (34.8%), p = .371]. Non-use of hydroxychloroquine (adjusted odds ratio [aOR] 18.83, 95% CI: 1.97, 179.60, p = .011) and a SELENA-SLEDAI score ≥8 within 12 months prior to vaccination (aOR 5.33, 95% CI: 1.38, 20.55, p = .015) were independent factors of disease flares. An increment in post-vaccine renal flare rate was observed [6 (8.7%) versus 14 (20.3%), p = .046]. Among 14 adoSLE patients with renal flare, 13 (92.9%) patients had previous lupus nephritis, and new-onset proteinuria or increased proteinuria (71.4%) was the most common finding. Thirty-four (49.3%) patients contracted COVID-19 within a year post-vaccination, all presenting with mild to moderate symptoms; among the 46 patients who received a booter, 15 (32.6%) experienced COVID-19.ConclusionsCOVID-19 vaccination is effective and safe in preventing severe COVID-19 among adoSLE patients, without increasing annual SLE flare rates. However, close monitoring for renal flares is recommended, particularly for patients with a history of LN. Although vaccinated adoSLE patients contracted COVID-19, their outcomes were favorable.

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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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