ABSTRACT
Objective: The effect of biological agents used in severe allergic diseases on the risk of coronavirus disease 2019 (COVID-19) and the course of the disease still remains unclear. The aim of the study was to evaluate retrospectively the frequency and severity of COVID-19 to determine risk factors and to present real-life data in patients using biological agents.Materials and Methods: Patients who have used omalizumab or mepolizumab for at least six months were questioned retrospectively in terms of a history of COVID-19. Patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) polymerase chain reaction (PCR) or serological IgG positivity, symptoms, lung involvement, the need for supplemental oxygen, hospital and intensive care admission, and mortality were queried. Results: Of the 71 patients (omalizumab/mepolizumab: 51/20) included in the study, the average age was 37.2 +/- 12.9, and the female/ male ratio was 46/25. Of the 11 patients (omalizumab/mepolizumab: 6/5) with SARS-CoV-2 positivity, two were hospitalized for pneumonia and needed oxygen. However, intensive care was not required and they survived. There was no significant difference between mepolizumab users who had COVID-19 and those who did not in terms of baseline and post-treatment 6th-month eosinophil values (p= 0.7, p= 0.59, respectively). It was established that eosinopenia developing after treatment did not increase the risk of COVID-19 in patients using mepolizumab [RR (95% Cl) 0.99 (0.97-1.02), p=0.88].Conclusion: According to our single center data, we found the risk of severe COVID-19 in patients using biological agents to be quite low. Especially, eosinopenia that developed after mepolizumab treatment did not constitute a risk factor for the severity of COVID-19.
ABSTRACT
Objective: Although the factors that trigger and exacerbate chronic spontaneous urticaria (CSU) are well known, there is still a lack of information about the effects of COVID-19 vaccines on CSU. This study aimed to investigate exacerbations/relapses triggered by COVID-19 vaccines in patients with CSU who are well controlled with treatment or in remission. Materials and Methods: The study included 350 CSU patients. Demographic and clinical characteristics were collected from patients' medical records. The seven-day urticaria activity score (UAS7) and urticaria control test (UCT) were evaluated separately during the onset of the disease, pre-vaccination, and post-vaccination periods. Results: The mean age was 39.89 +/- 13.30 years and 74.6% of the patients were female. A total of 227 patients were vaccinated with the Pfizer/BioNTech mRNA vaccine, 67 with the Sinovac/CoronaVac inactivated vaccine, and 54 with both vaccines. Urticaria exacerbations/ relapses were observed in a total of 76 patients, and most CSU exacerbations/relapses occurred after the first dose (n=46). Median UAS7 scores increased significantly in the post-vaccination period in patients who experienced urticaria exacerbation (p<0.0001). Median UCT scores were significantly decreased due to urticaria exacerbation with vaccination (p<0.0001). Conclusion: Both mRNA and inactivated COVID-19 vaccine may lead to exacerbations or relapses in patients with CSU. Even so, exacerbations/relapses associated with COVID-19 vaccines can be easily controlled with treatments and do not preclude subsequent doses.