Tolerability of COVID-19 Infection and Messenger RNA Vaccination Among Patients With a History of Kawasaki Disease.
Tolerability of COVID-19 Infection and Messenger RNA Vaccination Among Patients With a History of Kawasaki Disease.
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DOI：
10.1001/jamanetworkopen.2022.26236
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发表时间：
2022-08-01
影响因子：
13.8
通讯作者：
中科院分区：
文献类型：
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有川崎病史的患者在接触SARS-CoV-2感染或接种疫苗后的临床结局如何？在该病例系列中，153例有川崎病、SARS-CoV-2感染和/或疫苗接种史的患者耐受良好，没有不良事件或住院记录。这些发现表明，有川崎病史的患者可以耐受SARS-CoV-2感染或疫苗接种。该病例系列使用现有数据库描述了川崎病患者在SARS-CoV-2感染或接受信使RNA（mRNA）疫苗后的临床结局。川崎（KD）症状与COVID-19引起的儿童多系统炎症综合征显著重叠。KD患者可能因暴露于SARS-CoV-2感染或接种疫苗而面临不良结局的风险。描述SARS-CoV-2感染或疫苗接种后KD患者的结局。该病例系列使用现有KD数据库评价了2个队列，并通过电子病历（包括华盛顿州免疫记录）审查了2020年1月1日至2022年1月31日期间的个体电子病历。疫苗队列入选标准包括免疫接种时21岁或以下，并接受1次或多次BNT 162 b2（Pfizer-BioNTech）或信使RNA（mRNA）-1273（Moderna）疫苗剂量。COVID-19队列包括21岁或21岁以下SARS-CoV-2聚合酶链反应或核衣壳IgG阳性的患者。参与者包括来自预先存在的KD数据库的826名患者。153例患者接受了至少1剂BNT 162 b2或mRNA-1273疫苗，并被纳入mRNA疫苗队列。37名患者的SARS-CoV-2检测结果呈阳性，并被纳入COVID-19队列。SARS-CoV-2疫苗接种和/或感染。mRNA疫苗接种和/或COVID-19后的不良事件，包括临床医生就诊、急诊科就诊或住院。在纳入mRNA疫苗接种队列的153例患者中（平均[SD]年龄，13.0 [4.3]岁; 94例男性[61.4%]），143例（93.5%）接受了BNT 162 b2疫苗，其余10例（6.5%）接受了mRNA-1273或两者的组合。在疫苗队列的患者中，129名（84.3%）完全接种疫苗或接受第三剂加强剂。没有发生临床严重不良事件，也没有疫苗相关住院或门诊就诊的报告。COVID-19队列包括37例患者（平均[SD]年龄，11.0 [5.5]岁; 22例男性[59.5%]）。没有患者因COVID-19而需要住院。最常见的症状包括低烧、疲劳、咳嗽和肌痛，并在几天内消退。两名患者，年龄分别为9岁和19岁，咳嗽和疲劳持续3至4周。1例患者在接受静脉注射免疫球蛋白治疗KD后6周内发生COVID-19。这些发现表明，mRNA疫苗可能是安全的，对于有KD病史的患者，COVID-19可能不严重。
What are the clinical outcomes of patients with a history of Kawasaki disease after exposure to SARS-CoV-2 infection or vaccination? In this case series of 153 patients with a history of Kawasaki disease, SARS-CoV-2 infection and/or vaccination was well tolerated, with no adverse events or hospital admissions documented. These findings suggest that patients with history of Kawasaki disease tolerate SARS-CoV-2 infection or vaccination. This case series uses an existing database to describe clinical outcomes of patients with Kawasaki disease after SARS-CoV-2 infection or receipt of messenger RNA (mRNA) vaccine. Kawasaki disease (KD) symptoms significantly overlap with multisystem inflammatory syndrome in children due to COVID-19. Patients with KD may be at risk for adverse outcomes from exposure to SARS-CoV-2 infection or vaccination. To describe the outcomes of patients with KD to SARS-CoV-2 infection or vaccination. This case series evaluated 2 cohorts using an existing KD database and reviewed individual electronic medical records for the period spanning January 1, 2020, through January 31, 2022, via electronic medical records that include Washington state immunization records. Vaccine cohort inclusion criteria consisted of being 21 years or younger at immunization and receiving 1 or more BNT162b2 (Pfizer-BioNTech) or messenger RNA (mRNA)–1273 (Moderna) vaccine doses. The COVID-19 cohort included patients 21 years or younger with positive polymerase chain reaction or nuclear capsid IgG findings for SARS-CoV-2. Participants included 826 patients from a preexisting KD database. One hundred fifty-three patients received at least 1 BNT162b2 or mRNA-1273 vaccine dose and were included in the mRNA vaccine cohort. Thirty-seven patients had positive test results for SARS-CoV-2 and were included in the COVID-19 cohort. SARS-CoV-2 vaccination and/or infection. Adverse events after mRNA vaccination and/or COVID-19, including clinician visits, emergency department encounters, or hospitalizations. Among the 153 patients included in the mRNA vaccination cohort (mean [SD] age, 13.0 [4.3] years; 94 male [61.4%]), the BNT162b2 vaccine was provided for 143 (93.5%), and the remaining 10 (6.5%) received mRNA-1273 or a combination of both. Among patients in the vaccine cohort, 129 (84.3%) were fully vaccinated or received a third-dose booster. No clinically severe adverse events occurred, and there were no reports of vaccine-related hospitalizations or outpatient visits. The COVID-19 cohort included 37 patients (mean [SD] age, 11.0 [5.5] years; 22 male [59.5%]). No patients required hospitalization due to COVID-19. The most common symptoms included low-grade fever, fatigue, cough, and myalgia with resolution within a few days. Two patients, aged 9 and 19 years, had extended cough and fatigue for 3 to 4 weeks. One patient developed COVID-19 within 6 weeks of receiving intravenous immunoglobulin for KD. These findings suggest that the mRNA vaccines may be safe and COVID-19 may not be severe for patients with a history of KD.
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DOI：
10.1056/nejmoa2116298
发表时间：
2022-01-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Walter EB;Talaat KR;Sabharwal C;Gurtman A;Lockhart S;Paulsen GC;Barnett ED;Muñoz FM;Maldonado Y;Pahud BA;Domachowske JB;Simões EAF;Sarwar UN;Kitchin N;Cunliffe L;Rojo P;Kuchar E;Rämet M;Munjal I;Perez JL;Frenck RW Jr;Lagkadinou E;Swanson KA;Ma H;Xu X;Koury K;Mather S;Belanger TJ;Cooper D;Türeci Ö;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591007 Clinical Trial Group
通讯作者：
C4591007 Clinical Trial Group
影响因子：
16.6
作者：
通讯作者：
--
DOI：
10.1016/s2665-9913(22)00001-7
发表时间：
2022-04
期刊：
The Lancet. Rheumatology
影响因子：
--
作者：
Putman M;Kennedy K;Sirotich E;Liew JW;Sattui SE;Moni TT;Akpabio AA;Alpizar-Rodriguez D;Angevare S;Beesley RP;Berenbaum F;Bulina I;Chock YPE;Conway R;Duarte-García A;Singh AD;Duff E;Durrant KL;Gheita TA;Hill CL;Howard R;Hoyer BF;Hsieh E;El Kibbi L;Kilian A;Kim AHJ;Liew DFL;Lo C;Mateus EF;Miller B;Mingolla S;Nudel M;Singh JA;Singh N;Ugarte-Gil MF;Wallace J;Young KJ;Zamora-Tehozol EA;Bhana S;Costello W;Grainger R;Machado PM;Robinson PC;Sufka P;Wallace ZS;Yazdany J;Harrison C;Larché MJ;Levine M;Foster G;Thabane L;Hausmann JS;Sparks JA;Simard JF
通讯作者：
Simard JF
影响因子：
4.2
作者：
Arslanoglu Aydin, Elif;Baglan, Esra;Bulbul, Mehmet
通讯作者：
Bulbul, Mehmet
影响因子：
37.8
作者：
McCrindle, Brian W.;Rowley, Anne H.;Pahl, Elfriede
通讯作者：
Pahl, Elfriede