Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review

Joudeh, Anwar I.; Lutf, Abdu Qaid; Mahdi, Salah; Tran, Gui

doi:10.1016/j.vaccine.2023.05.048

Cited by 5 publications

(5 citation statements)

References 66 publications

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“…Regardless of the lower antibody titers in autoimmune patients, a potential increase in titer could be achieved after administering a third dose of vaccine, though the titer was still lower compared with a healthy control group. Evidence from a study by Joudeh et al indicates that a booster vaccine dose is associated with a higher seroconversion rate, particularly in patients with a history of COVID-19 infection [ 108 ]. Further evidence comes from Cardelli, et al, who showed that a time-dependent decrease in protective antibody titer was restored after receipt of a booster dose.…”

Section: Discussionmentioning

confidence: 99%

Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Patients with Autoimmune Diseases: A Systematic Review and Meta-Analysis

Widhani,

Hasibuan,

Rismawati

et al. 2023

Vaccines

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Patients with autoimmune diseases are among the susceptible groups to COVID-19 infection because of the complexity of their conditions and the side effects of the immunosuppressive drugs used to treat them. They might show impaired immunogenicity to COVID-19 vaccines and have a higher risk of developing COVID-19. Using a systematic review and meta-analysis, this research sought to summarize the evidence on COVID-19 vaccine efficacy, immunogenicity, and safety in patients with autoimmune diseases following predefined eligibility criteria. Research articles were obtained from an initial search up to 26 September 2022 from PubMed, Embase, EBSCOhost, ProQuest, MedRxiv, bioRxiv, SSRN, EuroPMC, and the Cochrane Center of Randomized Controlled Trials (CCRCT). Of 76 eligible studies obtained, 29, 54, and 38 studies were included in systematic reviews of efficacy, immunogenicity, and safety, respectively, and 6, 18, and 4 studies were included in meta-analyses for efficacy, immunogenicity, and safety, respectively. From the meta-analyses, patients with autoimmune diseases showed more frequent breakthrough COVID-19 infections and lower total antibody (TAb) titers, IgG seroconversion, and neutralizing antibodies after inactivated COVID-19 vaccination compared with healthy controls. They also had more local and systemic adverse events after the first dose of inactivated vaccination compared with healthy controls. After COVID-19 mRNA vaccination, patients with autoimmune diseases had lower TAb titers and IgG seroconversion compared with healthy controls.

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Section: Discussionmentioning

confidence: 99%

Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Patients with Autoimmune Diseases: A Systematic Review and Meta-Analysis

Widhani,

Hasibuan,

Rismawati

et al. 2023

Vaccines

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“…This is similar to the 2.4–3.4% of unexpected splicing events we observed for the C1 and C62 transcriptomes in this work. Since its first use, over 2 billion doses of the ChAdOx1 nCOV-19 vaccine have been administered, particularly in India, South America and Africa, without any reported evidence that rare aberrant splice variants of the spike transcript caused ill effects in vaccine recipients [ 67 , 68 , 69 ].…”

Section: Discussionmentioning

confidence: 99%

Adenovirus Transcriptome in Human Cells Infected with ChAdOx1-Vectored Candidate HIV-1 Vaccine Is Dominated by High Levels of Correctly Spliced HIVconsv1&62 Transgene RNA

et al. 2023

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We develop candidate HIV-1 vaccines, of which two components, ChAdOx1.tHIVconsv1 (C1) and ChAdOx1.HIVconsv62 (C62), are delivered by the simian adenovirus-derived vaccine vector ChAdOx1. Aberrant adenovirus RNA splicing involving transgene(s) coding for the SARS-CoV-2 spike was suggested as an aetiology of rare adverse events temporarily associated with the initial deployment of adenovirus-vectored vaccines during the COVID-19 pandemic. Here, to eliminate this theoretically plausible splicing phenomenon from the list of possible pathomechanisms for our HIV-1 vaccine candidates, we directly sequenced mRNAs in C1- and C62-infected nonpermissive MRC-5 and A549 and permissive HEK293 human cell lines. Our two main observations in nonpermissive human cells, which are most similar to those which become infected after the intramuscular administration of vaccines into human volunteers, were that (i) the dominant adenovirus vector-derived mRNAs were the expected transcripts coding for the HIVconsvX immunogens and (ii) atypical splicing events within the synthetic open reading frame of the two transgenes are rare. We conclude that inadvertent RNA splicing is not a safety concern for the two tested candidate HIV-1 vaccines.

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“…The occurrence of a new rheumatic disease due to the COVID-19 vaccination has only been documented in sporadic cases. Joudeh et al [77] summarized reports of 127 patients (data extracted from 69 case reports or case series) with or without rheumatic diseases. Based on these reports, the authors found that de novo diagnoses occurred in patients receiving mRNA vaccines, aged > 50 years, and from 1 day to 4 weeks after vaccination [77].…”

Section: Covid-19 Prophylaxismentioning

confidence: 99%

“…Joudeh et al [77] summarized reports of 127 patients (data extracted from 69 case reports or case series) with or without rheumatic diseases. Based on these reports, the authors found that de novo diagnoses occurred in patients receiving mRNA vaccines, aged > 50 years, and from 1 day to 4 weeks after vaccination [77]. Among these cases, PMR was diagnosed most frequently, with 32 cases reported [77].…”

Section: Covid-19 Prophylaxismentioning

confidence: 99%

“…Based on these reports, the authors found that de novo diagnoses occurred in patients receiving mRNA vaccines, aged > 50 years, and from 1 day to 4 weeks after vaccination [77]. Among these cases, PMR was diagnosed most frequently, with 32 cases reported [77]. Comparison of the frequency of diagnosing a new inflammatory rheumatic disease as a sequela of COVID-19 or as a side effect of the vaccination revealed an increased incidence of PMR after vaccination compared to COVID-19 convalescence (33.1% vs. 21.3%, p = 0.032) [78].…”

Section: Covid-19 Prophylaxismentioning

confidence: 99%

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COVID-19 prophylaxis, diagnostics, and treatment in patients with rheumatic diseases. The Polish experts panel opinion

Kwiatkowska,

Krajewska-Włodarczyk,

Batko

et al. 2024

Reumatologia

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As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evolves, infection management in vulnerable populations requires formalized guidance. Although low-virulence variants of SARS-CoV-2 remain predominant, they pose an increased risk of severe illness in adults with rheumatic and musculoskeletal diseases (RMDs). Several disease-specific (chronic long-grade inflammation, concomitant immunosuppression) and individual (advanced age, multimorbidity, pregnancy, vaccination status) factors contribute to excess risk in RMD populations. Various post-COVID-19 manifestations are also increasingly reported and appear more commonly than in the general population. At a pathogenetic level, complex interplay involving innate and acquired immune dysregulation, viral persistence, and genetic predisposition shapes a unique susceptibility profile. Moreover, incident cases of SARS-CoV-2 infection as a trigger factor for the development of autoimmune conditions have been reported. Vaccination remains a key preventive strategy, and encouraging active education and awareness will be crucial for rheumatologists in the upcoming years. In patients with RMDs, COVID-19 vaccines’ benefits outweigh the risks. Derivation of specialized diagnostic and therapeutic protocols within a comprehensive COVID-19 care plan represents an ideal scenario for healthcare system organization. Vigilance for symptoms of infection and rapid diagnosis are key for introducing antiviral treatment in patients with RMDs in a timely manner. This review provides updated guidance on optimal immunization, diagnosis, and antiviral treatment strategies.

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Efficacy and safety of mRNA and AstraZeneca COVID-19 vaccines in patients with autoimmune rheumatic diseases: A systematic review

Cited by 5 publications

References 66 publications

Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Patients with Autoimmune Diseases: A Systematic Review and Meta-Analysis

Efficacy, Immunogenicity, and Safety of COVID-19 Vaccines in Patients with Autoimmune Diseases: A Systematic Review and Meta-Analysis

Adenovirus Transcriptome in Human Cells Infected with ChAdOx1-Vectored Candidate HIV-1 Vaccine Is Dominated by High Levels of Correctly Spliced HIVconsv1&62 Transgene RNA

COVID-19 prophylaxis, diagnostics, and treatment in patients with rheumatic diseases. The Polish experts panel opinion

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