Frontiers in Immunology (Mar 2023)

A deep look into the storm: Israeli multi-center experience of coronavirus disease 2019 (COVID-19) in patients with autoimmune inflammatory rheumatic diseases before and after vaccinations

  • Fadi Kharouf,
  • Fadi Kharouf,
  • Tali Eviatar,
  • Tali Eviatar,
  • Maya Braun,
  • Elisheva Pokroy-Shapira,
  • Elisheva Pokroy-Shapira,
  • Michal Brodavka,
  • Michal Brodavka,
  • Yair Zloof,
  • Nancy Agmon-Levin,
  • Nancy Agmon-Levin,
  • Kochava Toledano,
  • Kochava Toledano,
  • Shirly Oren,
  • Shirly Oren,
  • Merav Lidar,
  • Merav Lidar,
  • Devy Zisman,
  • Devy Zisman,
  • Yonit Tavor,
  • Yonit Tavor,
  • Mirit Amit-Vazina,
  • Mirit Amit-Vazina,
  • Firas Sabbah,
  • Gabriel S. Breuer,
  • Gabriel S. Breuer,
  • Amir Dagan,
  • Amir Dagan,
  • Rima Beshara-Garzuzi,
  • Rima Beshara-Garzuzi,
  • Doron Markovits,
  • Doron Markovits,
  • Muna Elias,
  • Muna Elias,
  • Joy Feld,
  • Joy Feld,
  • Oshrat Tayer-Shifman,
  • Oshrat Tayer-Shifman,
  • Tal Gazitt,
  • Tal Gazitt,
  • Tatiana Reitblatt,
  • Limor Rubin,
  • Limor Rubin,
  • Amir Haddad,
  • Amir Haddad,
  • Sami Giryes,
  • Sami Giryes,
  • Daphna Paran,
  • Daphna Paran,
  • Hagit Peleg,
  • Hagit Peleg,
  • Yair Molad,
  • Yair Molad,
  • Ori Elkayam,
  • Ori Elkayam,
  • Dror Mevorach,
  • Dror Mevorach,
  • Alexandra Balbir-Gurman,
  • Alexandra Balbir-Gurman,
  • Yolanda Braun-Moscovici,
  • Yolanda Braun-Moscovici

DOI
https://doi.org/10.3389/fimmu.2023.1064839
Journal volume & issue
Vol. 14

Abstract

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ObjectiveWe aimed to characterize the course of COVID-19 in autoimmune inflammatory rheumatic disease (AIIRD) patients in Israel, taking into consideration several remarkable aspects, including the outcomes of the different outbreaks, the effect of vaccination campaigns, and AIIRD activity post-recovery.MethodsWe established a national registry of AIIRD patients diagnosed with COVID-19, including demographic data, AIIRD diagnosis, duration and systemic involvement, comorbidities, date of COVID-19 diagnosis, clinical course, and dates of vaccinations. COVID-19 was diagnosed by a positive SARS-CoV-2 polymerase chain reaction.ResultsIsrael experienced 4 outbreaks of COVID-19 until 30.11.2021. The first three outbreaks (1.3.2020 – 30.4.2021) comprised 298 AIIRD patients. 64.9% had a mild disease and 24.2% had a severe course; 161 (53.3%) patients were hospitalized, 27 (8.9%) died. The 4th outbreak (delta variant), starting 6 months after the beginning of the vaccination campaign comprised 110 patients. Despite similar demographic and clinical characteristics, a smaller proportion of AIIRD patients had negative outcomes as compared to the first 3 outbreaks, with regards to severity (16 patients,14.5%), hospitalization (29 patients, 26.4%) and death (7 patients, 6.4%). COVID-19 did not seem to influence the AIIRD activity 1-3 months post-recovery.ConclusionsCOVID-19 is more severe and has an increased mortality in active AIIRD patients with systemic involvement, older age and comorbidities. Vaccination with 3 doses of the mRNA vaccine against SARS-CoV-2 protected from severe COVID-19, hospitalization and death during the 4th outbreak. The pattern of spread of COVID-19 in AIIRD patients was similar to the general population.

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