Impact of COVID-19 and COVID-19 vaccination on high-risk patients with antiphospholipid syndrome: a nationwide survey
Impact of COVID-19 and COVID-19 vaccination on high-risk patients with antiphospholipid syndrome: a nationwide survey
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DOI：
10.1093/rheumatology/keac224
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发表时间：
2022-04-12
期刊：
影响因子：
5.5
通讯作者：
Denas, Gentian
中科院分区：
文献类型：
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作者：
Pengo, Vittorio;Del Ross, Teresa;Denas, Gentian
目的APS和aPL三阳性患者是复发事件的高危人群。由于COVID-19和COVID-19疫苗接种可能诱导血栓性并发症，研究的目的是评估这些患者接种疫苗后的COVID-19病程和不良事件。方法：这是一项全国性的多中心调查，在9个APS转诊中心进行问卷调查。纳入的患者为间隔12周确认为三阳性aPL的血栓性APS。参考专家医生使用了4级COVID-19严重程度量表[从0（无症状）到3（在重症监护室住院）]和6级疫苗接种不良反应量表[从0（暂时性局部注射部位体征/症状）到5（可能危及生命的反应）]。在30天内考虑结果。结果在161名受访患者中，18名（11%）患有COVID-19。所有患者均完全恢复，无任何进展至重度疾病或血栓栓塞事件。共有146名患者（92%）和129名（80%）接受了第一剂疫苗;副作用很小，在大多数情况下（第一剂疫苗接种后83%，第二剂疫苗接种后68%）仅限于手臂疼痛。他们大多对接种疫苗的必要性提出质疑，抱怨安全性差，并普遍不愿意接种COVID-19疫苗。结论三阳性血栓性APS患者不会发生严重的COVID-19结局。重要的是，COVID-19疫苗接种耐受性良好。这些数据可能会让患者和医生放心，并有助于减少未接种疫苗患者的犹豫。
Objectives Patients with APS and triple-positive for aPL are at high risk of recurrent events. As COVID-19 and COVID-19 vaccination may induce thrombotic complications, the objective of the study was to assess the course of COVID-19 and adverse events after vaccination in these patients. Methods This is a nationwide multicentre survey conducted in nine APS referral centres by means of a questionnaire. Included patients are thrombotic APS with triple-positive aPL confirmed 12 weeks apart. Reference specialist physicians used a four-graded scale of severity for COVID-19 [from 0 (asymptomatic) to 3 (hospitalization in intensive care unit)] and a six-graded scale for adverse reactions to vaccination [from 0 (transient local injection site sign/symptoms) to 5 (potentially life-threatening reactions)]. Outcomes were considered within a 30-day period. Results Out of 161 patients interviewed, 18 (11%) had COVID-19. All of them fully recovered without any progression to severe disease nor thromboembolic event. A total of 146 patients received the first (92%) and 129 (80%) the second dose of vaccine; side effects were minimal and, in most cases (83% after the first and 68% after the second vaccination) limited to a sore arm. Fifteen patients (9%) were unvaccinated. Most of them raised doubts on the need for vaccination, complained of poor safety and in general were reluctant about COVID-19 vaccination. Conclusion Patients with triple-positive thrombotic APS did not suffer from severe COVID-19 outcomes. Importantly, COVID-19 vaccination was well tolerated. These data may reassure patients and physicians and contribute to reducing hesitancy in unvaccinated patients.