Identification of a Vulnerable Group for Post-Acute Sequelae of SARS-CoV-2 (PASC): People with Autoimmune Diseases Recover More Slowly from COVID-19

Dreyer, Nancy A; Petruski‐Ivleva, Natalia; Albert, Lisa; Mohamed, Damir; Brinkley, Emma; Reynolds, Matthew W.; Toovey, Stephen

doi:10.2147/ijgm.s313486

Cited by 20 publications

(15 citation statements)

References 19 publications

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“…We have previously reported that people with autoimmune disorders appeared to be particularly vulnerable to COVID-19, and their response to COVID-19 vaccination may possibly relate to this susceptibility. [11] In contrast, those with diabetes were less likely than others to report vaccine side effects. The lower reporting rates for diabetics may be influenced by an overlap in potential side effects with their metabolic disorder, or they may have found the vaccine associated side effects rather insignificant as a result.…”

Section: Discussionmentioning

confidence: 99%

How frequent are acute reactions to COVID-19 vaccination and who is at risk?

Dreyer

Reynolds

Albert

et al. 2022

Vaccine

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Introduction Our objective was to describe and compare self-reported side effects of COVID-19 vaccines in the USA. Methods A web-based registry enrolled volunteers who received a COVID-19 vaccine between March 19 –July 15, 2021. We collected self-reported short-term side effects, medical consultation, hospitalization, and quality of life impact following completed vaccination regimens (Pfizer, Moderna, J&J). Results We recruited 6,966 volunteers who completed their full course of vaccination (median age 48 years, IQR 35.0-62.0; 83.6% female): Pfizer 3,486; Moderna 2,857; J&J 623. Few (3.1%) sought medical care for post-vaccination side effects. Hospitalization (n=17; 0.3%) and severe allergic reactions (n=39; 0.6%) also were rare. Those with autoimmune disease or lung disease were approximately twice as likely to seek medical care (adjusted odds ratio (aOR) 2.01 [95% CI: 1.39;2.92] and 1.70 [95% CI: 1.12;2.58] respectively). 92.4% of participants reported ≥1 side effect (median 3), with injection site reactions (78.9%), fatigue (70.3%), headache (49.0%) reported most frequently. More side effects were reported after the second dose of two-dose vaccines (medians: 1 vs. 2 for Pfizer and 1 vs. 3 for Moderna for first and second doses respectively) versus 3 for J&J's single-dose vaccine. For the employed, the median number of workdays missed was one. Diabetics and those vaccinated against influenza were substantially less likely to report 3 or more symptoms (aOR 0.68, 95% CI 0.56,0.82 and aOR 0.82, 95% CI 0.73,0.93, respectively.) Discussion The total side effect burden was, not unexpectedly, greater with two-dose regimens but all three vaccines appear relatively safe. Very few subjects reported side effects serious enough to warrant medical care or reported post-vaccination hospitalization. While these findings do not address possible long-term effects, they do inform on their short-term safety and tolerability and will hopefully provide some reassurance and positively inform the benefit-risk and pharmacoeconomic assessment for all three vaccines. See Clinicaltrials.gov NCT04368065

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Section: Discussionmentioning

confidence: 99%

How frequent are acute reactions to COVID-19 vaccination and who is at risk?

Dreyer

Reynolds

Albert

et al. 2022

Vaccine

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“…Substantial heterogeneity across studies was observed in each of the three meta-analyses (I 2 =98.8%, 97.4% and 95.9%, respectively; p<0.001). ASADI-POOYA [24] AUL [91] AYDIN [65] BALDINI [62] FERNÁNDEZ-DE-LAS-PEÑAS [105] SUÁREZ-ROBLES [128] DARCIS [101] DREYER [103] ZAYET [137] YOMOGIDA [34] VENTURELLI [135] VARGHESE [134] TAYLOR [131] TAWFIK [14] SZEKELY [66] SULTANA [129] STAVEM [127] SONNWEBER [58] RIGHI [123] PELUSO [13] O'SULLIVAN [122] O'KEEFE [121] NAIK [54] MOTIEJUNAITE [64] MECHI [44] MALLIA [115] KLEIN [111] GABER [106] EROL [25] DIAZ-FUENTES [102] DANKOWSKI [100] CARFI [96] CORTÉS-TELLES [69] CARVALHO-SCHNEIDER [97] BOARI [94] VIJAYAKUMAR [65] Total (I 2 =95.9%, p<0.001) ZHANG [39] D'CRUZ [35] D'CRUZ [35] TODT [132] TAYLOR [131] SKJORTEN [38] DAYNES [10] APARISI [26] DE GRAAF [61] YIN …”

Section: Prevalence Of Post-covid Breathlessness Among Covid-19 Survi...mentioning

confidence: 99%

Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis

Zheng

Daines²,

Han³

et al. 2022

Eur Respir Rev

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Persistent breathlessness >28 days after acute COVID-19 infection has been identified as a highly debilitating post-COVID symptom. However, the prevalence, risk factors, mechanisms and treatments for post-COVID breathlessness remain poorly understood. We systematically searched PubMed and Embase for relevant studies published from 1 January 2020 to 1 November 2021 (PROSPERO registration number: CRD42021285733) and included 119 eligible papers. Random-effects meta-analysis of 42 872 patients with COVID-19 reported in 102 papers found an overall prevalence of post-COVID breathlessness of 26% (95% CI 23–29) when measuring the presence/absence of the symptom, and 41% (95% CI 34–48) when using Medical Research Council (MRC)/modified MRC dyspnoea scale. The pooled prevalence decreased significantly from 1–6 months to 7–12 months post-infection. Post-COVID breathlessness was more common in those with severe/critical acute infection, those who were hospitalised and females, and was less likely to be reported by patients in Asia than those in Europe or North America. Multiple pathophysiological mechanisms have been proposed (including deconditioning, restrictive/obstructive airflow limitation, systemic inflammation, impaired mental health), but the body of evidence remains inconclusive. Seven cohort studies and one randomised controlled trial suggested rehabilitation exercises may reduce post-COVID breathlessness. There is an urgent need for mechanistic research and development of interventions for the prevention and treatment of post-COVID breathlessness.

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“…CARE was launched on April 2, 2020 to study COVID-19 symptoms and severity outside of the hospital setting to examine what factors, if any, mitigate the impact of infection with COVID-19. [20][21][22] The protocol and web technology are updated periodically, with the COVID-19 vaccination questions reported here added on December 15, 2020. Participants are recruited via social media, targeting adult US residents, and are not compensated for participation.…”

Section: Methodsmentioning

confidence: 99%

COVID-19 Vaccination Breakthrough Infections in a Real-World Setting: Using Community Reporters to Evaluate Vaccine Effectiveness

Reynolds¹,

Xie²,

Knuth³

et al. 2022

IDR

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Purpose Coronavirus disease 2019 (COVID-19) has highlighted the need for new methods of pharmacovigilance. Here, we use adult community volunteers to obtain systematic information on vaccine effectiveness and the nature and severity of breakthrough infections. Methods Between December 15, 2020 and September 16, 2021, 11,826 unpaid community-based volunteers reported the following information to an on-line registry: COVID-19 test results, vaccination (Pfizer, Moderna, or Johnson & Johnson) and COVID-19 symptoms. COVID-19 infections were described based on vaccination status at the time of infection: 1) fully vaccinated, 2) partially vaccinated (received first of two-dose vaccines or were <14 days post-final dose), or 3) unvaccinated. Results Among 8554 participants who received any COVID-19 vaccine, COVID-19 infections were reported by 74 (1.0%) of those who were fully vaccinated and 198 (2.3%) of those who were partially vaccinated at the time of infection. Among the 74 participants who reported a breakthrough infection after full vaccination, the median time from vaccination to reported positive test result was 104.5 days (interquartile range: 77–135 days), with no difference among vaccine manufacturers. One quarter (25.7%) of breakthrough infections in the fully vaccinated cases were asymptomatic and most (>97%) fully vaccinated participants reported no symptoms or only mild symptoms compared to 89.3% of the unvaccinated cases. Only 1.4% of fully vaccinated participants reported experiencing at least 3 moderate-to-severe symptoms compared to 7.8% in the unvaccinated. Conclusion Person-generated health data, also referred to as patient-reported outcomes, is a useful approach for quantifying breakthrough infections and their severity and for comparing vaccines. Trial Registration Clinicaltrials.gov NCT04368065, EU PAS Register EUPAS36240.

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Identification of a Vulnerable Group for Post-Acute Sequelae of SARS-CoV-2 (PASC): People with Autoimmune Diseases Recover More Slowly from COVID-19

Cited by 20 publications

References 19 publications

How frequent are acute reactions to COVID-19 vaccination and who is at risk?

How frequent are acute reactions to COVID-19 vaccination and who is at risk?

Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis

COVID-19 Vaccination Breakthrough Infections in a Real-World Setting: Using Community Reporters to Evaluate Vaccine Effectiveness

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