Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Kocatürk, Emek; Salameh, Pascale; Saraç, Esra; Ayala, Carolina Elisa Vera; Thomsen, Simon Francis; Zuberbier, Torsten; Ensina, Luis Felipe; Popov, Todor A.; Doorn, Martijn van; Giménez‐Arnau, Ana; Asero, Riccardo; Criado, Paulo Ricardo; Grattan, Clive; Conlon, Niall; Chérrez-Ojeda, Iván; Aarestrup, Fernando Monteiro; Ansari, Zainab; Abri, Salma Al; Ahmad, Mona Al; Hinai, Bushra Al; Al‐Nesf, Maryam; Allenova, Anastasiia; Altrichter, Sabine; Arnaout, Rand; Bartosińska, Joanna; Palitot, Esther Bastos; Bauer, Andrea; Bernstein, Jonathan A.; Bizjak, M; Bonnekoh, Hanna; Bouillet, Laurence; Brzoza, Zenon; Carne, Emily; Purayil, Saleema; Chong-Neto, Herberto José; Christoff, George; Criado, Roberta F. J.; Cvenkel, Klara; Damadoğlu, Ebru; Данилычева, И В; Day, Cascia; Montjoye, Laurence de; Demir, Semra; Ferucci, Silvia Mariel; Fomina, Daria; Kalyoncu, Alı Fuat; Fukunaga, Atsushi; García, Elizabeth; Gelincik, Aslı; Göbel, Joe Hannah; Godse, Kiran; Gonçalo, Margarida; Gotua, Maia; Gugala, Agata; Guillet, Carole; Karakaya, Gül; Kasperska−Zając, Alicja; Katelaris, Constance H.; Khoshkhui, Maryam; Kleinheinz, Andreas; Kołacińska-Flont, Marta; Kolkhir, Pavel; Košnik, Mitja; Krasowska, Dorota; Kumaran, Muthu Sendhil; Kupryś‐Lipińska, Izabela; Kurowski, Marcin; Larenas‐Linnemann, Désirée; Lee, Youngsoo; Campinhos, Fernanda Lugão; Makris, Michael; Gómez, René Maximiliano; Meshkova, Raisa; Moura, Ana; Nasr, Iman; Neisinger, Sophia; Oda, Yoshiko; Kara, Rabia Öztaş; Papapostolou, Niki; Parisi, Claudio Alberto Salvador; Pesqué, David; Peter, Jonny; Petkova, Elena; Ridge, Katie; Rudenko, Michael; Rutkowski, Chris; Saini, Sarbjit S.; Salman, Andaç; Sánchez, Jorge; Şekerel, Bülent Enis; Serpa, Faradiba Sarquis; Dikicier, Bahar Sevimli; Sidiropoulos, Nikitas; Sørensen, Jennifer Astrup; Soria, Angèle; Küçük, Özlem Su; Thalappil, Sherin; Tomaszewska, Katarzyna; Tuncay, Gülseren; Ünal, Derya; Valle, Solange Oliveira Rodrigues; Lindonk, Esmee van; Vestergaard, Christian; Vitchuk, Aleksandr V.; Xepapadaki, Paraskevi; Ye, Young-Min; Zalewska-Janowska, Anna; Sikora, Agnieszka; Zamłyński, Mateusz; Serdotetskova, Sofia A.; Lebedkina, Marina S.; Kuznetsova, Elizaveta V.; Maurer, Marcus

doi:10.1016/j.jaci.2023.07.019

Cited by 7 publications

(1 citation statement)

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“…The lack of direct link with COVID is also supported by the low infection rate reported in our initial survey as well as by the anti-nucleocapsid data and neutralizing activities against the Omicron (BA.1 and BA.2) variants. Finally, reinfection with SARS-CoV-2 only led to CU exacerbation in a minority of cases (15%) corroborating the data from the UCARE COVAC-CU study who found a rate of COVID-19 vaccination-induced CU exacerbation of 9% (27).…”

Section: Discussionsupporting

confidence: 82%

Features of chronic urticaria after COVID-19 mRNA vaccine, a real-life cohort study

Muller,

Foglierini,

Pescosolido

et al. 2024

Preprint

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Background New onsets of chronic urticaria (CU) have been reported after repeated immunizations, mainly with the Moderna mRNA-1273 vaccine (Spikevax) Objective This study aims to evaluate patients with CU after COVID-19 mRNA vaccination. The contribution of SARS-Cov2 infection, atopy and IgE against the vaccine was analyzed. Methods We monitored the features of patients who developed CU after vaccination in the Canton of Vaud through two surveys conducted in 2022 and 2023. Fifty individuals with CU underwent blood tests, and their results were compared with individuals without a history of urticaria (N=135). The presence of anti-vaccine IgE was detected with basophil activation tests (BAT). We assessed anti-SARS-Cov2 humoral response, and the presence of IgEs against common respiratory allergens (Phadiatop) as a surrogate for atopy. Results Post-vaccination CU occurred after a median interval of 10 days and significantly more after the Spikevax booster, affecting middle-aged individuals (median 41, 66% females). In 2023, CU was still active in 53% of the cases. Inducible forms of CU, primarily dermographism, were reported in 54% (2022) and 61% (2023) of the cases. BAT positivity was not specific to CU, anti-nucleocapsid positivity, or atopy but was significantly associated with higher anti-spike neutralizing activities and younger age. Four CU patients tolerated an additional dose of mRNA vaccine with no disease exacerbation/recurrence. Conclusion The Spikevax booster induced anti-vaccine IgE independently of CU, the latter being not directly associated with COVID-19 infection nor atopy. The tolerance to a new booster in 4/4 patients suggests that the Spikevax vaccine indirectly triggered CU in predisposed individuals.

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Section: Discussionsupporting

confidence: 82%