Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination

Šinkovec Savšek, Tjaša (avtor), Zajc Avramovič, Mojca (avtor), Avčin, Tadej (avtor), Korva, Miša (avtor), Avšič-Županc, Tatjana (avtor), Toplak, Nataša (avtor)

Background Paediatric patients with autoimmune rheumatic diseases (pARD) are often immunocompromised because of the disease and/or the therapy they receive. At the beginning of COVID-19 pandemic there was a greatconcern about the possibility of severe SARS-CoV-2 infection in these patients. The best method of protection is vaccination, so as soon as vaccine was licenced, we aimed to vaccinate them. Data on disease relapse rate after COVID-19 infection and vaccination are scarce, but they play important role in everyday clinical decisions. Methods The aim of this study was to determine the relapse rate of autoimmune rheumatic disease (ARD) after COVID-19 infection and vaccination. Data on demographic, diagnosis, disease activity, therapy, clinical presentation of the infection and serology were collected from pARD who had COVID-19 and from pARD who were vaccinated against COVID-19, from March 2020 to April 2022. All vaccinated patients received two doses of the BNT162b2 BioNTech vaccine, on average, 3.7 (S.D.=1.4) weeks apart. Activity of the ARD was followed prospectively. Relapse was defined as a worsening of the ARD in a time frame of 8 weeks after infection or vaccination. For statistical analysis, Fisher’s exact test and Mann-Whitney U test were used. Results We collected data from 115 pARD, which we divided into two groups. We included 92 pARD after infection and 47 after vaccination, with 24 in both groups (they were infected before/after vaccination). In 92 pARD we registered 103 SARS-CoV-2 infections. Infection was asymptomatic in 14%, mild in 67% and moderate in 18%, 1% required hospitalization; 10% had a relapse of ARD after infection and 6% after vaccination. There was a trend towards higher disease relapse rate after infection compared to vaccination, but the difference was not statistically significant (p=0.76). No statistically significant difference was detected in the relapse rate depending on the clinical presentation of the infection (p=0.25) or the severity of the clinical presentation of COVID-19 between vaccinated and unvaccinated pARD (p=0.31). Conclusions There is a trend towards a higher relapse rate in pARD after infection compared to vaccination and connection between the severity of COVID-19 and vaccination status is plausible. Our results were, however, not statistically significant.

• Jezik: Angleški jezik
• Ključne besede: inflammatory multisystem syndrome, acute respiratory syndrome, COVID-19, child
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2023
• Št. strani: 8 str.
• Številčenje: Vol. 21, no. 46
• PID: 20.500.12556/RUL-189877
• UDK: 61
• ISSN pri članku: 1546-0096
• DOI: 10.1186/s12969-023-00829-4
• COBISS.SI-ID: 159185667
• Datum objave v RUL: 19.10.2026

Gradivo je del revije

• Naslov: Pediatric rheumatology online journal
• Skrajšan naslov: Pediatr. rheumatol. online j.
• Založnik: BioMed Central
• ISSN: 1546-0096
• COBISS.SI-ID: 21482457

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

• Licenca: CC0 1.0, Creative Commons CC0 1.0 Univerzalna
• Povezava: https://creativecommons.org/publicdomain/zero/1.0/deed.sl
• Opis: CC Zero omogoča znanstvenikom, izobraževalcem, umetnikom in drugim ustvarjalcem ter lastnikom vsebin, zavarovanih z avtorsko pravico ali zbirko podatkov, da se odpovejo pravicam na svojih delih in jih tako čim bolj celovito predajo v javno domeno, da bodo drugi lahko prosto gradili, izboljševali in ponovno uporabljali dela za kakršne koli namene brez omejitev v skladu z zakonodajo o avtorskih pravicah ali zbirkah podatkov.

Projekti

• Financer: University Medical Centre Ljubljana
• Številka projekta: 20220051

• Financer: ARRS - Agencija za raziskovalno dejavnost Republike Slovenije
• Številka projekta: J3-3061
• Naslov: Klinične, imunološke in genetske značilnosti večorganskega vnetnega sindroma povezanega s COVID-19 pri otrocih in mladostnikih