Effects of Vaccination against COVID-19 in Chronic Spontaneous and Inducible Urticaria (CSU/CIU) Patients: A Monocentric Study

Grieco, Teresa; Ambrosio, Luca; Trovato, Federica; Vitiello, Martina; Demofonte, Ilaria; Fantò, M.; Paolino, Giovanni; Pellacani, Giovanni

doi:10.3390/jcm11071822

Cited by 13 publications

(18 citation statements)

References 23 publications

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“…Another recent study carried out on adult patients is in line with our data, as the relapse rate of CU after the first vaccine dose is very similar to ours (8.12%), and the average duration of relapse is less than 7 days (2 days and 11 hours). 30 Two similar adult-onset cases were described in a study in which patients with a history of CSU experienced a relapse of urticaria after the first dose of the COVID-19 vaccine. 31 On comparing the percentage of patients with CSU relapse or worsening after COVID-19 (19.2%) with the percentage of patients with CSU relapse or worsening after COVID-19 vaccination (7.7%), quite similar results were obtained.…”

Section: Discussionmentioning

confidence: 85%

Relapse or worsening of chronic spontaneous urticaria during SARS-CoV-2 infection and vaccination in children: A telemedicine follow-up

Lascialfari

Sarti

Barni

et al. 2022

Allergol Immunopathol

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Background: Chronic urticaria (CU), characterized by daily wheals and/or angioedema lasting more than 6 weeks, is a common skin disease. CU is classified as spontaneous or inducible. Because of Coronavirus Disease-19 (COVID-19) pandemic, face-to-face visits were reduced, and many centers started remote consultations to minimize hospital admissions and risk for viral diffusion. Telemedicine became a valuable tool for evaluating and monitoring patients with chronic diseases, such as CU. This study aims to evaluate the effectiveness of tele-medicine as a means for the follow-up of patients with chronic spontaneous urticaria (CSU) during the COVID-19 pandemic. In particular, we collected data related to CSU evolution and treatment by remote consultation. Moreover, we specifically investigated the impact of SARS-CoV-2 infection or vaccination on CSU in relapsing or worsening of such a disease.Methods: The electronic charts were reviewed for patients diagnosed with CSU, who were referred to the allergy unit of Meyer Children’s Hospital, Florence. For each patient, a review of demographic characteristics, diagnostic workup, efficacy, and tolerability of the treatment was performed. Patients with a physical agent triggering CU were excluded from the study. Disease activity was monitored using the Urticaria Activity Score (UAS7). In addition, when the COVID-19 pandemic started, follow-up continued through telemedicine after an initial face-to-face visit when possible. Approximately 1 year after the diagnosis of CSU, patients were recontacted to investigate whether they had experienced a relapse or worsening of urticaria during a possible COVID-19 or immediately after receiving a COVID-19 vaccine.Results: From January 2020 to March 2021, 84 cases of CSU were identified, with 71 (84.5%) of these being evaluated via televisit (remote consultation). During the remote follow-up period, 38/71 (53.5%) patients who were evaluated via televisit recovered completely from CSU, while 24 (33.8%) made therapy adjustments, and 9 (12.7%) had to discontinue follow-up through remote visits and return to face-to-face visits. In February 2022, we recontacted the 71 patients with CSU, and 50 (70.4%) of them answered by phone call interview. Four (19.2%) of the 26 patients who had COVID-19 showed CSU relapse, while 1 (3.8%) had a CSU worsening. Instead, 1 (3.8%) patient of the 26 who were vaccinated had a relapse of CSU, and 1 (3.8%) had a worsening of CSU, both after the first dose.Conclusion: Our data showed that telemedicine can be an effective tool for the follow-up of patients with CSU. Moreover, COVID-19, as well as COVID-19 vaccination, may trigger CSU relapse or worsening, but both are unspecific triggers, and urticaria shows a very short duration in most cases.

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Section: Discussionmentioning

confidence: 85%

Relapse or worsening of chronic spontaneous urticaria during SARS-CoV-2 infection and vaccination in children: A telemedicine follow-up

Lascialfari

Sarti

Barni

et al. 2022

Allergol Immunopathol

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“…The rate of allergic reactions to Pfizer-BioNTech vaccine is higher among patients with allergies, particularly among a subgroup with a history of high-risk allergies. The literature suggests that most patients with a history of allergic diseases and, particularly, highly allergic patients can be safely immunized at certain medical facilities and/or referral centers after completing a risk assessment questionnaire [6]. Further studies are required to define more specific risk factors predisposing to Type I hypersensitivity to COVID-19 vaccines.…”

Section: Discussionmentioning

confidence: 99%

“…A careful analysis of the reported cases of severe allergic reaction to vaccines has shown that they are very rare and mostly related to certain ingredients, such as polyethylene glycol and polysorbate, which are used as excipients [3]. The most frequently reported cutaneous manifestations that present after more than 24 h after the vaccine include the "COVID arm", or the onset of sometimes erythematous, painful patches, located at the injection site; urticaria-like skin reactions; exanthema-like eruptions, erythema multiforme, erythematous lesions in the lower limbs, pityriasis rosea, lymphomatoid drug reactions and flare up of psoriasis [1,[4][5][6]. Herein, we aim to describe cases of patients referred to our outpatient clinic with cutaneous manifestations following COVID-19 vaccination.…”

Section: Introductionmentioning

confidence: 99%

Cutaneous Reactions to COVID-19 Vaccines in a Monocentric Study: A Case Series

Cantisani

Chello

Grieco

et al. 2022

JCM

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After coronavirus disease 2019 (COVID-19) caused a global pandemic, vaccines were rapidly developed to control the spread of the virus. Although they were effective in most of the cases at protecting people from becoming seriously ill and being hospitalized, they showed side effects, too. Among other adverse vaccine reactions, cutaneous eruptions following SARS-CoV-2 have been described in the literature, but they are not well-characterized yet. We described the morphology and timing of the spectrum of cutaneous reactions following most of the COVID-19 vaccines available in Italy, which were observed in outpatients referred to our non-invasive diagnostic clinic. Most of these reactions appeared after the second or third COVID-19 vaccine dose (most of them after mRNA COVID-19 vaccines). Our data support that cutaneous reactions to COVID-19 vaccination are generally self-limited; in addition, history of allergic reaction to a specific food, medicine or vaccine should not discourage vaccination in the general population, although patients with immune dysregulation should be accurately selected and monitored. Further research is necessary to better assess the true prevalence and preventive measures of skin reactions to COVID-19 vaccination.

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“…A recently published study similarly reported that 92% of 160 CSU patients did not experience a relapse in symptoms after vaccination against COVID‐19. 5 However, our results may be limited owing to the small sample size, and most of our patients had only mild CSU activity. In conclusion, we have demonstrated that the mRNA COVID‐19 vaccine does not induce flares of mild to moderate severity CSU (UAS7 ≤27).…”

mentioning

confidence: 81%