Outcomes of COVID‐19 vaccination in 323 patients with clonal and non‐clonal mast cell activation disorders

Giannetti, Matthew P.; Olivieri, Francesco; Godwin, Grace; Weller, Emma; Nicoloro‐SantaBarbara, Jennifer; Bonadonna, Patrizia; Zanotti, Roberta; Zanoni, Giovanna; Hartmann, Karin; Castells, Mariana

doi:10.1111/all.15476

Cited by 8 publications

(11 citation statements)

References 8 publications

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“…On the other hand, our results are comparable with the largest study published to date on this topic in patients with MC activation disorders, which shows a prevalence of adverse reactions of 6% [ 30 ].…”

Section: Discussionsupporting

confidence: 87%

Safety and Tolerability of COVID-19 Vaccine in Mast Cell Disorders Real-Life Data from a Single Centre in Italy

Nicola,

Mazzola,

Lo Sardo

et al. 2024

Vaccines

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Background In the past three years, COVID-19 has had a significant impact on the healthcare systems and people’s safety worldwide. Mass vaccinations dramatically improved the health and economic damage caused by SARS-CoV-2. However, the safety of COVID-19 vaccines in patients at high risk of allergic reactions still has many unmet needs that should be clarified. Material and methods A retrospective, single-centre study was performed by collecting demographic and clinical data of patients with Mast Cell Disorders (MCDs) to evaluate the safety and tolerability of COVID-19 vaccinations. Moreover, any changes in the natural history of the underlying disease following the vaccine have been evaluated. Results This study included 66 patients affected with MCDs. Out of them, 52 (78.8%) received a COVID-19 vaccination and 41 (78.8%) completed the vaccination course. Premedication came first in 86.6% of our patients. A total of seven (4.5%) patients complained about an immediate reaction and two (1.3%) had a late reaction. Worsening of MCD history was observed in a single patient. Conclusions Despite the overall high risk of allergic reactions, our study did not reveal any increased risk for SARS-CoV-2 allergic reactions in MCD patients, thus supporting the recommendation in favour of the SARS-CoV-2 vaccination. However, due to the potentially increased rate of anaphylactic reactions, MCD patients should receive vaccine premedication and should be treated in a hospital setting after an allergological specialistic evaluation.

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Section: Discussionsupporting

confidence: 87%

Safety and Tolerability of COVID-19 Vaccine in Mast Cell Disorders Real-Life Data from a Single Centre in Italy

Nicola,

Mazzola,

Lo Sardo

et al. 2024

Vaccines

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“…We determined an overall prevalence of hypersensitivity to NSAIDs as 11.3% in the total study cohort. This is a 4- to 5-fold increased risk compared to the general population, where a prevalence of 0.6 to 2.5% has been reported ( 16 ). However, this is similar to adult asthmatic patients, where the prevalence NSAID hypersensitivity ranges from 4.3 to 11% ( 23 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

“…In one of these reports, authors evaluated different anesthetic techniques, such as general, epidural, and local anesthesia and sedation, in 501 mastocytosis patients by reviewing 676 procedures and reported an increased frequency of perioperative anaphylaxis in adult mastocytosis patients who previously presented with anaphylaxis ( 13 ). In contrast, although anaphylactic reactions were expected to be more frequent in patients with mastocytosis, this has not thus far been the case with reactions to COVID-19 vaccines ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 91%

Non-steroidal anti-inflammatory drug-induced anaphylaxis infrequent in 388 patients with mastocytosis: A two-center retrospective cohort study

et al. 2022

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BackgroundAnaphylaxis is a well-known feature of mastocytosis, particularly in relation to hymenoptera venom stings. It is therefore hypothesized that mastocytosis patients may also be predisposed to severe hypersensitivity reactions to certain medications including non-steroidal anti-inflammatory drugs (NSAIDs). For this reason, these patients are usually discouraged from using these drugs. The current study aimed to determine the prevalence and evaluate the severity of NSAID-related hypersensitivity reactions among patients with mastocytosis.MethodsA retrospective study was conducted among a total of 388 (≥18 years old) consecutive patients from two independent European mastocytosis centers, in Sweden and Italy. Patients underwent a thorough allergy work-up where self-reported NSAID-hypersensitivity reactions were re-evaluated by an allergist in the first cohort (202 patients) and results were validated in the second cohort (186 patients).ResultsOverall frequency of NSAID-hypersensitivity was 11.3% in the total study cohort. Most patients reacted with cutaneous symptoms (89%), whereas severe hypersensitivity reactions were infrequent with only 11 patients (2.8%) experiencing anaphylaxis. All NSAID-related hypersensitivity reactions had occurred before mastocytosis was diagnosed. There was no difference between the groups regarding gender, baseline tryptase levels or presence of atopy, asthma/rhinitis.ConclusionOur study indicates an approximate 4-fold increased prevalence of NSAID hypersensitivity among mastocytosis patients compared to the general population. However, most NSAID reactions were limited to the skin as the prevalence of overall anaphylaxis was infrequent. Our results support that mastocytosis patients with a known tolerance to NSAIDs can continue using these medications without special precautions, whereas those with a prior reaction to NSAIDs should undergo thorough allergy work-up, including drug challenges.

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“…These fears may have been unfounded, as recent reports indicate that COVID-19 mortality is comparable to that of the general population 5 and that COVID-19 vaccination is safe in patients with MC disorders. 6 Cellular ACE2 receptors are thought to play a critical role in allowing COVID-19 to enter the cell and ultimately cause infection. 7 The absence of this receptor in bone marrow and oral mucosal MCs 5,8 may explain the low incidence of MC activation symptoms during COVID-19 infection by excluding direct infection of the MC 5 as seen in previous reports 5,6 and our present study.…”

Section: Discussionmentioning

confidence: 99%

“…6 Cellular ACE2 receptors are thought to play a critical role in allowing COVID-19 to enter the cell and ultimately cause infection. 7 The absence of this receptor in bone marrow and oral mucosal MCs 5,8 may explain the low incidence of MC activation symptoms during COVID-19 infection by excluding direct infection of the MC 5 as seen in previous reports 5,6 and our present study.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 infection and vaccination in 92 pediatric patients with cutaneous mastocytosis: A retrospective, cross‐sectional study

López Sanz,

Guerrero Ramírez,

Manso Córdoba

et al. 2024

Pediatric Dermatology

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Mast cells (MCs) can release a variety of biologically active mediators under different circumstances, such as fever or vaccination. Our aim was to evaluate the incidence and severity of MC activation symptoms induced by SARS‐CoV‐2 virus (COVID‐19) infection and vaccination in a cohort of 92 pediatric patients with cutaneous mastocytosis. Our findings support previous evidence on the safety of COVID‐19 infection and vaccination in patients with MC disorders.

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Outcomes of COVID‐19 vaccination in 323 patients with clonal and non‐clonal mast cell activation disorders

Cited by 8 publications

References 8 publications

Safety and Tolerability of COVID-19 Vaccine in Mast Cell Disorders Real-Life Data from a Single Centre in Italy

Safety and Tolerability of COVID-19 Vaccine in Mast Cell Disorders Real-Life Data from a Single Centre in Italy

Non-steroidal anti-inflammatory drug-induced anaphylaxis infrequent in 388 patients with mastocytosis: A two-center retrospective cohort study

COVID‐19 infection and vaccination in 92 pediatric patients with cutaneous mastocytosis: A retrospective, cross‐sectional study

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