ABSTRACT
BACKGROUND: It is a well-known fact that patients with chronic urticaria (CU) are not at a higher risk for a serious allergic reaction such as anaphylaxis from medications. However, there is a fear and some misconceptions regarding allergic reactions to the COVID-19 vaccine among patients and physicians, which might result in resistance to vaccination. Data about the incidence and severity of COVID-19 vaccine reactions in the CU population are scarce. In this study, we aimed to evaluate the real-world (Qatar) experience of the effects of COVID-19 vaccination on patients with CU and analyze the rates of vaccine-associated reactions and risk factors associated. METHODS: This is a cross-sectional questionnaire-based study conducted as a part of COVAC-CU international under the GALEN UCARE program. Adult patients with CU who received one or more doses of COVID-19 vaccination were administered a questionnaire regarding their demographic characteristics and any potential unfavorable effect of the vaccination from the November 03 to December 31, 2021. RESULTS: These are preliminary results from an ongoing study. The data were collected from 91 patients with CU, of whom 79.12% had chronic spontaneous urticaria, 15.3% had chronic inducible urticaria, and the remaining had both. Of these patients, 74.7% were women. The average age of the patients was 39.3 (range 15-68) years. The majority (84.6%) of them received 2 vaccine doses, 13.1% received 3 doses, and the remaining received 1 dose. Most (70.3%) of these patients did not experience any worsening in CU after vaccination. A total of 62.6% patients reported some type of side effects to the vaccine (16.4% had CU exacerbation and 46.1% other types of reactions, such as fever and muscle pain). None of the patients reported anaphylaxis. Two patients reported improvement in their symptoms. CONCLUSION: Our local data suggest that patients with CU in Qatar can safely take the COVID-19 vaccine. Most patients with CU did not experience any worsening in symptoms, and there were no reports of a severe reaction (anaphylaxis). We recommend maximizing symptom control prior to vaccination to minimize the risk of worsening urticarial symptoms.
ABSTRACT
INTRODUCTION: The COVID-19 pandemic dramatically disrupts health care around the globe. The impact of the pandemic on chronic urticaria (CU) and its management are largely unknown. AIM: To understand how CU patients are affected by the COVID-19 pandemic; how specialists alter CU patient management; and the course of CU in patients with COVID-19. MATERIALS AND METHODS: Our cross-sectional, international, questionnaire-based, multicenter UCARE COVID-CU study assessed the impact of the pandemic on patient consultations, remote treatment, changes in medications, and clinical consequences. RESULTS: The COVID-19 pandemic severely impairs CU patient care, with less than 50% of the weekly numbers of patients treated as compared to before the pandemic. Reduced patient referrals and clinic hours were the major reasons. Almost half of responding UCARE physicians were involved in COVID-19 patient care, which negatively impacted on the care of urticaria patients. The rate of face-to-face consultations decreased by 62%, from 90% to less than half, whereas the rate of remote consultations increased by more than 600%, from one in 10 to more than two thirds. Cyclosporine and systemic corticosteroids, but not antihistamines or omalizumab, are used less during the pandemic. CU does not affect the course of COVID-19, but COVID-19 results in CU exacerbation in one of three patients, with higher rates in patients with severe COVID-19. CONCLUSIONS: The COVID-19 pandemic brings major changes and challenges for CU patients and their physicians. The long-term consequences of these changes, especially the increased use of remote consultations, require careful evaluation.