Frontiers in Immunology (Jul 2023)

The impact of SARS-CoV-2 infection and vaccination on inflammatory arthritis: a cohort study

  • Giovanni Striani,
  • Ariela Hoxha,
  • Mariagrazia Lorenzin,
  • Giacomo Cozzi,
  • Laura Scagnellato,
  • Tatiana Vangelista,
  • Francesca Frizzera,
  • Pierino De Sandre,
  • Paolo Simioni,
  • Andrea Doria,
  • Roberta Ramonda

DOI
https://doi.org/10.3389/fimmu.2023.1207015
Journal volume & issue
Vol. 14

Abstract

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ObjectivesTo investigate the effects of SARS-CoV-2 infection, as well as short- (within 48 hours) and long-term (within 30 days) adverse events (AEs) of SARS-CoV-2 vaccines, including arthritis flares in a large cohort of patients with inflammatory arthritis (IA).MethodsA retrospective cohort study comprising 362 patients: 94 (26%) rheumatoid arthritis, 158 (43.6%) psoriatic arthritis and 110 (30.4%) ankylosing spondylitis; and 165 healthy controls (HC) to ascertain the prevalence and severity of SARS-CoV-2 infection in patients with IA, the rate of AEs associated with SARS-CoV-2 vaccines and disease flares within a month of the vaccination. All patients provided informed consent and data about SARS-CoV-2 infection and/or vaccination status.ResultsOne-hundred-seventeen (32.3%) patients and 39 (23.6%) HC were affected by SARS-CoV-2 infection. Forty (34.2%) patients experienced an IA flare within one month of infection, of whom 3 (7.5%) needed to switch therapy. The prevalence of SARS-CoV-2 infection, disease severity, and hospitalization rate were not significantly different. At least one shot of SARS-CoV-2 vaccine was administered in 331 (91.4%) patients and 147 (89.1%) HC. Within 48 hours, 102 (30.8%) patients developed vaccine-related AEs; 52 (15.7%) patients with >1 vaccine dose experienced an IA flare-up, of whom 12 (23.1%) needed to switch therapy.ConclusionsA significantly higher rate of IA flare was observed among patients who contracted SARS-CoV-2 infection vs. those without infection. Patients with IA experienced flares after SARS-CoV-2 vaccination, though it was not statistically significant.

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