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Risk and prognosis of SARS-CoV-2 infection and vaccination against SARS-CoV-2 in rheumatic and musculoskeletal diseases: a systematic literature review to inform EULAR recommendations.
Kroon, Féline P B; Najm, Aurélie; Alunno, Alessia; Schoones, Jan W; Landewé, Robert B M; Machado, Pedro M; Navarro-Compán, Victoria.
  • Kroon FPB; Rheumatology, Leiden University Medical Center, Leiden, The Netherlands fpbkroon@gmail.com.
  • Najm A; Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands.
  • Alunno A; Institute of Infection, Immunity and Inflammation, University of Glasgow College of Medical Veterinary and Life Sciences, Glasgow, UK.
  • Schoones JW; Internal Medicine and Nephrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
  • Landewé RBM; Directorate of Research Policy (formerly Walaeus Library), Leiden University Medical Center, Leiden, The Netherlands.
  • Machado PM; Rheumatology, Zuyderland Medical Center, Heerlen, The Netherlands.
  • Navarro-Compán V; Rheumatology & Clinical Immunology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Ann Rheum Dis ; 81(3): 422-432, 2022 03.
Article in English | MEDLINE | ID: covidwho-1560917
ABSTRACT

OBJECTIVES:

Perform a systematic literature review (SLR) on risk and prognosis of SARS-CoV-2 infection and vaccination against SARS-CoV-2 in patients with rheumatic and musculoskeletal diseases (RMDs).

METHODS:

Literature was searched up to 31 May 2021, including (randomised) controlled trials and observational studies with patients with RMD. Pending quality assessment, data extraction was performed and risk of bias (RoB) was assessed. Quality assessment required provision of (1) an appropriate COVID-19 case definition, and (2a) a base incidence (for incidence data) or (2b) a comparator, >10 cases with the outcome and risk estimates minimally adjusted for age, sex and comorbidities (for risk factor data).

RESULTS:

Of 5165 records, 208 were included, of which 90 passed quality assessment and data were extracted for incidence (n=42), risk factor (n=42) or vaccination (n=14). Most studies had unclear/high RoB. Generally, patients with RMDs do not face more risk of contracting SARS-CoV-2 (n=26 studies) or worse prognosis of COVID-19 (n=14) than individuals without RMDs. No consistent differences in risk of developing (severe) COVID-19 were found between different RMDs (n=19). Disease activity is associated with worse COVID-19 prognosis (n=2), possibly explaining the increased risk seen for glucocorticoid use (n=13). Rituximab is associated with worse COVID-19 prognosis (n=7) and possibly Janus kinase inhibitors (n=3). Vaccination is generally immunogenic, though antibody responses are lower than in controls. Vaccine immunogenicity is negatively associated with older age, rituximab and mycophenolate.

CONCLUSION:

This SLR informed the July 2021 update of the European Alliance of Associations for Rheumatology recommendations for the management of RMDs in the context of SARS-CoV-2.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Musculoskeletal Diseases / COVID-19 Vaccines / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Ann Rheum Dis Year: 2022 Document Type: Article Affiliation country: Annrheumdis-2021-221575

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Musculoskeletal Diseases / COVID-19 Vaccines / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Topics: Vaccines Limits: Adult / Female / Humans / Male / Middle aged Language: English Journal: Ann Rheum Dis Year: 2022 Document Type: Article Affiliation country: Annrheumdis-2021-221575