COVID-19 and Sarcoidosis, Readiness for Vaccination: Challenges and Opportunities

Manansala, Michael; Chopra, Amit; Baughman, Robert P.; Novak, Richard M.; Lower, Elyse E.; Culver, Daniel A.; Korsten, Peter; Drake, Wonder; Judson, Marc A.; Sweiss, Nadera J.

doi:10.3389/fmed.2021.672028

Cited by 18 publications

(18 citation statements)

References 37 publications

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“…Leading international sarcoidosis experts have formulated recommendations for the management of vaccinations and immunosuppressive therapies to protect this vulnerable patient population [36,37], and the rare occurrence of adverse immunological reactions, such as reported here, should not lead to an increased fear of vaccination in general.…”

Section: Discussionmentioning

confidence: 94%

First Report of Two Cases of Löfgren’s Syndrome after SARS-CoV-2 Vaccination-Coincidence or Causality?

2021

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Sarcoidosis can present as an acute form or take a chronic course. One of the acute presentations is Löfgren’s syndrome (LS), consisting of the symptom triad of bilateral hilar lymphadenopathy, erythema nodosum, and ankle periarthritis. In addition, there are occasional reports of sarcoid-like reactions following drug exposures. Nevertheless, reports of sarcoidosis or LS after vaccination have not been published. Here, we report two cases of de novo LS in a temporal association with different vaccines against the new coronavirus SARS-CoV-2. One patient developed the first symptoms three days after the second vaccination (first vaccination ChadOx-1, Astra Zeneca; second vaccination CX-024414, Moderna); in the second patient, symptoms started 28 days after the first vaccination (ChadOx-1, Astra Zeneca). Both patients eventually required treatment with glucocorticoids. Both patients achieved clinical improvement with treatment. In conclusion, we report the first two cases of LS shortly after SARS-CoV-2 vaccination.

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Section: Discussionmentioning

confidence: 94%

First Report of Two Cases of Löfgren’s Syndrome after SARS-CoV-2 Vaccination-Coincidence or Causality?

2021

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“…The same applies to circumscribed scleroderma (morphea), which was described in relation to vaccines in the past [88]. Similar to other inflammatory dermatoses, the potential risk of worsening of preexisting granulomatous or fibrogenic conditions should not deter the delivery of vaccinations to at-risk patients [89].…”

Section: Granulomatous and Fibrogenic Reactionsmentioning

confidence: 94%

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

et al. 2021

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(1) Background: Numerous vaccines are under preclinical and clinical development for prevention of severe course and lethal outcome of coronavirus disease 2019 (COVID-19). In light of high efficacy rates and satisfactory safety profiles, some agents have already reached approval and are now distributed worldwide, with varying availability. Real-world data on cutaneous adverse drug reactions (ADRs) remain limited. (2) Methods: We performed a literature research concerning cutaneous ADRs to different COVID-19 vaccines, and incorporated our own experiences. (3) Results: Injection site reactions are the most frequent side effects arising from all vaccine types. Moreover, delayed cutaneous ADRs may occur after several days, either as a primary manifestation or as a flare of a pre-existing inflammatory dermatosis. Cutaneous ADRs may be divided according to their cytokine profile, based on the preponderance of specific T-cell subsets (i.e., Th1, Th2, Th17/22, Tregs). Specific cutaneous ADRs mimic immunogenic reactions to the natural infection with SARS-CoV-2, which is associated with an abundance of type I interferons. (4) Conclusions: Further studies are required in order to determine the best suitable vaccine type for individual groups of patients, including patients suffering from chronic inflammatory dermatoses.

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“…Moreover, COVID19 per se has been associated with new onset of autoimmune diseases including sarcoidosis (11,12). Therefore, vaccination against SARS-CoV2 is recommended for patients of sarcoidosis (13).…”

Section: Discussionmentioning

confidence: 99%

Sarcoidosis presenting as bilateral optic neuritis after ChAdOx1 nCoV-19 vaccination

Shukla

Peter

Bhargava

et al. 2022

Monaldi Arch Chest Dis

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Sarcoidosis is an idiopathic granulomatous disease and can virtually affect any organ system. Multiple factors, including tubercular antigens organic and environmental exposures, have been implicated in its pathogenesis. In addition to drugs, sarcoid-like reactions have been reported following varicella and influenza vaccination. Few reports of erythema nodosum and Lofgren syndrome have been reported after the COVID19 vaccination, though no histologic diagnosis was pursued in these cases. We herein report a case of sarcoidosis presenting with bilateral acute onset vision loss with a temporal association with COVID19 vaccination (ChadOx-1 n-COV, COVISHIELDTM). Symptoms started within two weeks of receiving the vaccine. Alternate causes for optic neuritis were excluded. Transbronchial lung biopsy showed the presence of non-caseating epithelioid cell granulomas. The patient received high-dose corticosteroids immediately after diagnosis, albeit with incomplete clinical improvement in vision on a three-month follow-up. In conclusion, we report a novel case of sarcoidosis-related optic neuritis following COVID19 vaccination.

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COVID-19 and Sarcoidosis, Readiness for Vaccination: Challenges and Opportunities

Cited by 18 publications

References 37 publications

First Report of Two Cases of Löfgren’s Syndrome after SARS-CoV-2 Vaccination-Coincidence or Causality?

First Report of Two Cases of Löfgren’s Syndrome after SARS-CoV-2 Vaccination-Coincidence or Causality?

Cutaneous Adverse Reactions to COVID-19 Vaccines: Insights from an Immuno-Dermatological Perspective

Sarcoidosis presenting as bilateral optic neuritis after ChAdOx1 nCoV-19 vaccination

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