ABSTRACT
OBJECTIVE: An increasing number of new on-set autoimmune-inflammatory rheumatic diseases (AIRD) after COVID-19 vaccination has begun to be reported in the literature. In this article, we present our patients with new-onset AIRD after vaccination for COVID-19 and review the literature on the subject. PATIENTS AND METHODS: We investigated the clinical characteristics and laboratory parameters of previously described "newly developed AIRD in individuals recently vaccinated for COVID-19", in 22 cases vaccinated with one of the COVID-19 vaccines (BNT162b2 or CoronaVac) approved in our country. RESULTS: We collected 22 cases (14 female, 63.6%) that developed an AIRD after COVID-19 vaccination. Mean age was 53±14.4 (24-87) years. The interval between the last dose of vaccination and the development of the first complaint was 23.9±19.5 (4-90) days. CoronaVac was administered to four patients, and the BNT162b2 to 18 patients. AIRD-related symptoms developed in 12 patients after the first dose, in 8 patients after the second dose, and in two patients after the third dose. Twelve out of the 22 (54.5%) cases were diagnosed with rheumatoid arthritis, two with SLE, and the remaining eight patients each with leukocytoclastic vasculitis, Sjogren's syndrome, psoriatic arthritis, ankylosing spondylitis, systemic sclerosis, mixed connective tissue disease, eosinophilic granulomatosis with polyangiitis, and inflammatory myositis, respectively. Six patients had a history of documented antecedent COVID-19 infection. CONCLUSIONS: Autoimmune/inflammatory rheumatic diseases may develop after COVID-19 vaccinations. In the era of the COVID-19 pandemic, vaccination should be questioned carefully in newly diagnosed AIRD patients.
Subject(s)
Autoimmune Diseases , COVID-19 Vaccines , COVID-19 , Churg-Strauss Syndrome , Granulomatosis with Polyangiitis , Rheumatic Diseases , Adult , Aged , Female , Humans , Middle Aged , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Pandemics , Rheumatic Diseases/epidemiology , Vaccination/adverse effectsABSTRACT
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may trigger a cytokine storm, which is characterized by uncontrolled overproduction of proinflammatory cytokines. Objectives: We aimed to investigate the association between circulating levels of inflammatory cytokines and severity of coronavirus disease 2019 (COVID-19). Methods: This cross-sectional study included 46 severe and 32 mildly symptomatic COVID-19 patients. The serum levels of cytokines and chemokines were determined using the Bio-Plex Pro™ Human Cytokine Screening Panel. Results: Out of a total of 78 patients with confirmed COVID-19, 54 (69.2%) were males, and 24 (30.8%) were females. The mean age was 43.1 ± 13.3 and 58.2 ± 15 in mild and severe patients, respectively. Severe patients were characterized by significant laboratory abnormalities, such as increased WBC (P = 0.002) and neutrophil counts (P = 0.001), higher levels of ALT (P = 0.03), AST (P = 0.002), LDH (P < 0.001), urea (P = 0.013), ferritin (P < 0.001), D-dimer (P = 0.042), CRP (P < 0.001), and decreased lymphocyte (P < 0.001) and platelet (P = 0.045) counts. The levels of IL-6, IL-8, IL-13, TNF-α, IFN-γ, MIP-1β, and MCP-1 increased in the severe group compared to the mild group. However, significant differences were observed only for IL-6 (P < 0.001) and IL-8 (P < 0.001) levels. Conclusions: Serum IL-6 and IL-8 levels can be used as potential prognostic biomarkers of disease severity in COVID-19 patients. © 2021, Author(s).