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Immune-Mediated Diseases Following COVID-19 Vaccination: Report of a Teaching Hospital-Based Case-Series.
Liozon, Eric; Filloux, Matthieu; Parreau, Simon; Gondran, Guillaume; Bezanahary, Holy; Ly, Kim-Heang; Fauchais, Anne-Laure.
  • Liozon E; Departments of Internal Medicine, Dupuytren University Hospital, 87042 Limoges, France.
  • Filloux M; Department of Immunology and Immunogenetics, University Hospital of Limoges, 87042 Limoges, France.
  • Parreau S; Departments of Internal Medicine, Dupuytren University Hospital, 87042 Limoges, France.
  • Gondran G; Departments of Internal Medicine, Dupuytren University Hospital, 87042 Limoges, France.
  • Bezanahary H; Departments of Internal Medicine, Dupuytren University Hospital, 87042 Limoges, France.
  • Ly KH; Departments of Internal Medicine, Dupuytren University Hospital, 87042 Limoges, France.
  • Fauchais AL; Departments of Internal Medicine, Dupuytren University Hospital, 87042 Limoges, France.
J Clin Med ; 11(24)2022 Dec 16.
Article in English | MEDLINE | ID: covidwho-2163474
ABSTRACT
The occurrence and course of immune-mediated diseases (IMDs) following COVID-19 vaccination has been little explored so far. We retrieved, among adult patients hospitalized at the Internal Department of a French university hospital up to May 2022, all those who had developed, or relapsed to, an IMD less than 3 weeks following COVID-19 vaccination, without other triggers. Twenty-seven (24 new-onset) post-COVID-19 vaccine IMDs were recorded. They comprised giant cell arteritis or polymyalgia rheumatica (n = 16, HLA-DRB1*04 in 58% of 12 assessed GCA cases), immune-mediated necrotizing myositis or acute rhabdomyolysis, systemic vasculitis, immune thrombocytopenic purpura, rheumatoid arthritis, anti-synthetase syndrome, and adult-onset Still's disease. The causative vaccines were mRNA-based (20 cases) or viral vector-based (7 cases). The IMD typically occurred after the first vaccine dose, with an average delay of 8 (5 SD) days. The patients' mean age was 67 years, and 58% were women. The IMDs had protracted courses in all but three of the patients and typically required high-dose glucocorticoids, in combination with immunomodulators in 13 patients. One patient died of intractable rhabdomyolysis, whereas five suffered permanent damage from IMDs. Eleven patients with well-controlled IMDs completed their COVID-19 vaccination schedule, and two suffered mild IMD relapses. There is a risk of IMDs, notably GCA/PMR, and muscle disorders, following COVID-19 vaccination. Such adverse reactions typically occurred after the first dose, raising concern about subsequent COVID-19 vaccinations. However, early re-challenge in well-controlled IMDs appeared safe.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Topics: Long Covid / Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11247484

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Topics: Long Covid / Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Jcm11247484