Inflammatory rheumatic diseases with onset after SARS-CoV-2 infection or COVID-19 vaccination: a report of 267 cases from the COVID-19 and ASD group

Author:

Ursini FrancescoORCID,Ruscitti PieroORCID,Addimanda Olga,Foti Rosario,Raimondo Vincenzo,Murdaca Giuseppe,Caira Virginia,Pigatto Erika,Cuomo Giovanna,Lo Gullo AlbertoORCID,Cavazzana Ilaria,Campochiaro CorradoORCID,Naclerio Caterina,De Angelis Rossella,Ciaffi Jacopo,Mancarella Luana,Brusi Veronica,Marchetti Elena,Motta FrancescaORCID,Visentini Marcella,Lorusso Sebastiano,De Santis MariaORCID,De Luca Giacomo,Massaro Laura,Olivo Domenico,Pellegrini Roberta,Francioso Francesca,Luppino Jessica,Di Cola Ilenia,Foti Roberta,Varcasia Giuseppe,Caso Francesco,Reta Massimo,Dagna LorenzoORCID,Selmi CarloORCID,Iagnocco Annamaria,Giacomelli Roberto,Iannone Florenzo,Ferri ClodoveoORCID

Abstract

ObjectivesTo better define the spectrum of new-onset post-COVID-19 and post-COVID-19 vaccine inflammatory rheumatic diseases (IRD) from a large multicentric observational study.MethodsConsecutive cases of IRD encountered during a 12-month period and satisfying one of the following inclusion criteria: (a) onset of the rheumatic manifestations within 4 weeks from SARS-CoV-2 infection or (b) onset of the rheumatic manifestations within 4 weeks from the administration of one of the COVID-19 vaccines ws recruited.ResultsThe final analysis cohort comprised 267 patients, of which 122 (45.2%) in the post-COVID-19 and 145 (54.8%) in the postvaccine cohort. Distribution of IRD categories differed between the two cohorts: the post-COVID-19 cohort had a higher percentage of patients classified as having inflammatory joint diseases (IJD, 52.5% vs 37.2%, p=0.013) while the post-vaccine cohort had a higher prevalence of patients classified as polymyalgia rheumatica (PMR, 33.1% vs 21.3%, p=0.032). No differences were detected in the percentage of patients diagnosed with connective tissue diseases (CTD 19.7% vs 20.7%, p=0.837) or vasculitis (6.6% vs 9.0%, p=0.467). Despite the short follow-up period, IJD and PMR patients’ response to first-line therapy was favourable, with both groups achieving a drop in baseline disease activity scores of ~30% and ~70% respectively.ConclusionOur article reports the largest cohort published to date of new-onset IRD following SARS-CoV-2 infection or COVID-19 vaccines. Although causality cannot be ascertained, the spectrum of possible clinical manifestations is broad and includes IJD, PMR, CTD and vasculitis.

Publisher

BMJ

Subject

Immunology,Immunology and Allergy,Rheumatology

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