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Background: The Covid pandemic seems to have had several detrimental effects on managing patients affected by inherited metabolic diseases (IMD), although published data about the impact of COVID-19 on patients suffering from IMD are very scarce. The scope of our work was to evaluate adherence to the vaccination plan, the side effects experienced by our adult IMD patients, and the symptoms of the SARS-CoV-2 infection. Results: sixty-seven patients agreed to respond to a phone interview. The mean age was 36.5 (±11,6 SD). Regarding the vaccination campaign, fifty-five patients (82%) joined it, of whom ten have received two doses and the remaining forty-five, three. Forty-two patients (76%) reported adverse events following vaccination, the most frequent being local reaction, fever, and asthenia, which lasted an average of two days and resolved without sequelae. Regarding SARS-CoV-2 infection, twenty-seven out of sixty-seven patients (40%) have tested positive for the virus; seven of them were not vaccinated at the time of infection; on the other hand, twenty had already had at least two doses. Regarding the prevalence of long-Covid, as many as 12 patients (44%) reported symptoms that persisted after the nasopharyngeal swab tested negative and lasted an average of 81 (±74 SD) days. There were no statistically significant differences in BMI of patients who contracted the infection and patients who did not (25.15 vs 25.20, p=.861), between those who had adverse reactions to the vaccine and those who did not (24.40 vs 25.75, p=.223), between those who had long Covid and those who did not (25.9 vs 27.7, p=.183). No relation was observed between metabolic inherited disease, SARS-CoV-2 infection symptoms and adverse vaccine reactions. Conclusions: The data indicate that IMD patients adhered to the vaccination plan comparably to the general Italian population. Adverse events to the vaccine were negligible. SARS-CoV-2 infection, which occurred in most cases after receiving at least two doses of the vaccine, did not cause serious symptoms and never required hospitalisation. A non-negligible share of patients suffered from long Covid symptoms.

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