Characteristics of emerging new autoimmune diseases after COVID-19 vaccination: A sub-study by the COVAD group.
Journal: International journal of rheumatic diseases
Volume: 27
Issue: 5
Year of Publication: 2024
Affiliated Institutions:
Department of Rheumatology, Clinic of Rheumatology, University Hospital "St. Ivan Rilski", Medical University-Sofia, Sofia, Bulgaria.
Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Rheumatology, King's College Hospital NHS Foundation Trust, London, UK.
Medical College, Aga Khan University, Karachi, Pakistan.
Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai, Maharashtra, India.
Department of Clinical Immunology and Rheumatology, Institute of Post Graduate Medical Education and Research (PGIMER), Kolkata, West Bengal, India.
Department of Internal Medicine, University of Texas, Galveston, Texas, USA.
Department of Clinical Immunology, Medical Faculty, University Hospital "Lozenetz", Sofia University St. Kliment Ohridski, Sofia, Bulgaria.
Department of Internal Diseases Rheumatology Diabetology Geriatrics and Clinical Immunology with the Sub-Department of Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin, Poland.
Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India.
Department of Internal Medicine, General Hospital, National Medical Center "La Raza", Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Chair of the EULAR PARE Committee and Services Support Officer with Arthritis Ireland, Dublin, Ireland.
Maharashtra Institute of Medical Sciences and Research, Latur, Maharashtra, India.
EU Patient Advocacy Lead, Myositis Support and Understanding (MSU), Lincoln, Delaware, USA.
Research and Communications Specialist, The Myositis Association (TMA), Columbia, Maryland, USA.
Rheumatology Unit, Dipartimento di Medicine Interna e Terapia Medica, Università degli Studi di Pavia, Pavia, Italy.
Maulana Azad Medical College, Delhi, India.
Department of Rheumatology, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA.
Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Cali, Colombia.
Department of Medicine, Hospital Universidad del Norte, Barranquilla, Atlantico, Colombia.
Mymensingh Medical College, Mymensingh, Bangladesh.
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Department of Medicine and Therapeutics, College of Health Sciences, University of Ghana School of Medicine and Dentistry, Accra, Ghana.
Centre for Rheumatic Diseases, King's College London, London, UK.
Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK.
Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
Rheumatology Department, Saint-Joseph University, Beirut, Lebanon.
Medizinische Klinik - Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK.
Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Abstract summary
Despite the overall safety and efficacy of COVID-19 vaccinations, rare cases of systemic autoimmune diseases (SAIDs) have been reported post-vaccination. This study used a global survey to analyze SAIDs in susceptible individuals' post-vaccination.A cross-sectional study was conducted among participants with self-reported new-onset SAIDs using the COVID-19 Vaccination in Autoimmune Diseases (COVAD) 2 study dataset-a validated, patient-reported e-survey-to analyze the long-term safety of COVID-19 vaccines. Baseline characteristics of patients with new-onset SAIDs and vaccinated healthy controls (HCs) were compared after propensity score matching based on age and sex in a 1:4 ratio.Of 16 750 individuals, 74 (median age 52 years, 79.9% females, and 76.7% Caucasians) had new-onset SAID post-vaccination, mainly idiopathic inflammatory myopathies (IIMs) (n = 23, 31.51%), arthritis (n = 15; 20.53%), and polymyalgia rheumatica (PMR) (n = 12, 16.40%). Higher odds of new-onset SAIDs were noted among Caucasians (OR = 5.3; 95% CI = 2.9-9.7; p < .001) and Moderna vaccine recipients (OR = 2.7; 95% CI = 1.3-5.3; p = .004). New-onset SAIDs were associated with AID multimorbidity (OR = 1.4; 95% CI = 1.1-1.7; p < .001), mental health disorders (OR = 1.6; 95% CI = 1.3-1.9; p < .001), and mixed race (OR = 2.2; 95% CI = 1.2-4.2; p = .010), where those aged >60 years (OR = 0.6; 95% CI = 0.4-0.8; p = .007) and from high/medium human development index (HDI) countries (compared to very high HDI) reported fewer events than HCs.This study reports a low occurrence of new-onset SAIDs following COVID-19 vaccination, primarily IIMs, PMR, and inflammatory arthritis. Identified risk factors included pre-existing AID multimorbidity, mental health diseases, and mixed race. Revaccination was well tolerated by most patients; therefore, we recommend continuing COVID-19 vaccination in the general population. However, long-term studies are needed to understand the autoimmune phenomena arising post-vaccination.
Authors & Co-authors:
Shumnalieva Russka R
Ravichandran Naveen N
Hannah Jennifer J
Javaid Mahnoor M
Darooka Naitica N
Roy Debaditya D
Gonzalez Daniel E DE
Velikova Tsvetelina T
Milchert Marcin M
Kuwana Masataka M
Joshi Mrudula M
Gracia-Ramos Abraham Edgar AE
Boyd Peter P
Yaadav Praggya P
Cheng Karen K
Kobert Linda L
Cavagna Lorenzo L
Sen Parikshit P
Day Jessica J
Makol Ashima A
Gutiérrez Carlos Enrique Toro CET
Caballero-Uribe Carlo V CV
Saha Sreoshy S
Parodis Ioannis I
Dey Dzifa D
Nikiphorou Elena E
Distler Oliver O
Kadam Esha E
Tan Ai Lyn AL
Shinjo Samuel Katsuyuki SK
Ziade Nelly N
Knitza Johannes J
Chinoy Hector H
Aggarwal Rohit R
Agarwal Vikas V
Gupta Latika L
Study Outcome
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