Ab1291 covid-19 and Cryoglobulinemic VASCULITIS.LONG-TERM Survey Study on the Impact of Pandemic and Vaccination on a Large Patient’s Population

Abstract

BackgroundCryoglobulinemic Vasculitis (CV) is a rare autoimmune systemic disorder with multiple organ involvement. During the current COVID-19 pandemic, the patients with CV can accounted among frail populations because of the presence of multiple organ involvement, chronic steroid treatment, and more frequent old age.ObjectivesThe present study aimed to investigate the prevalence and outcome of COVID-19, as well the safety and immunogenicity of COVID-19 vaccines in a wide CV cohort by a multicenter survey.MethodsPatients with CV were consecutively recruited at 11 Italian referral centers. CV diagnosis, clinico-serological parameters, COVID-19 tests, and vaccination immunogenicity were carried out according to current methods.ResultsFour-hundred-thirty unselected CV patients (130 M; mean age 70±10.96 years) were recruited from February 2020 to October 2021. COVID-19 prevalence was significantly higher in CV patients compared to the Italian general population (11.9% vs 8.0%, p<0.005); furthermore, we observed a higher mortality in CV subjects with COVID-19 compared to those without (5.9% vs 0.5%, p<0.01). An older age (≥60 years) correlated with a worse COVID-19 outcome. Vaccine was administered in 87% of patients, and 50% received a boostering dose. Disease flares/worsening following the vaccination were significantly less frequent than those associated to COVID-19 (5% vs 14%, p=0.0012). CV patients showed an impaired vaccination immunogenicity compared to controls (p<0.05), as well an increased no-response rate after the booster.ConclusionCV patients have a higher risk to develop COVID-19, as well of more severe disease manifestations. Vaccines had a good safety profile in CV patients and of note, the vaccine-related side effects/disease flares were significantly lower compared to those COVID-19-related. However, a quarter of vaccinated individuals do not show detectable seroconversion; this is a major challenge for clinicians. Overall, a close monitoring of these frail patients during the ongoing pandemic is particularly advisable.References[1]Ferri C, et al. Ann Rheum Dis. 2020 Oct 14 doi: 10.1136/ annrheumdis-2020-219113.[2]Visentini M et al. Ann Rheum Dis. 2021 Nov 24. doi: 10.1136/ annrheumdis-2021-221248[3]Ferri C et al. J Autoimmun. 2022 Jul;131:102866. doi: 10.1016/jAcknowledgements:NIL.Disclosure of InterestsNone Declared.