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

COVID-19 SARS-CoV-2 chronic cutaneous reactions skin urticaria vaccines

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
25 Mar 2022
Historique:
received: 08 03 2022
revised: 22 03 2022
accepted: 23 03 2022
entrez: 12 4 2022
pubmed: 13 4 2022
medline: 13 4 2022
Statut: epublish

Résumé

Patients affected by pre-existing chronic spontaneous/Inducible urticaria (CSU/CIU) still feel unsafe due to the potential risk of an Adverse Event Following Immunization (AEFI) and Cutaneous Adverse Reactions (CARs) of COVID-19 vaccines. The appropriate management in this field remains debated and evidence is still lacking. We considered 160 CSU/CIU patients in Omalizumab/antihistamine therapy who received two doses of Comirnaty/Moderna mRNA vaccines; 20 of them also received a booster dose. Urticaria Activity Score-7 (UAS7) was used to assess the severity of the disease. Demographics, medical history, AEFI and CARs outcome after vaccination were collected by administering a web-based questionnaire completed by phone interview. In total, 147 patients did not show urticaria relapse (91.88%). Worsening cutaneous symptoms were experienced by 13 of our patients (8.12%). Exacerbation had a mean duration of 2 days and 11 h and mostly occurred after the first dose (69.23%). Systemic mild side effects were experienced by 9 patients (5.62%). No severe reactions were observed. Omalizumab can potentially prevent CARs and AEFI; however, major problems were registered during the 2-month stop period scheduled in the treatment. We suggest patients should not undergo vaccination during this period. CSU/CIU exacerbations appear to be transient and can be managed by antihistamines.

Sections du résumé

BACKGROUND BACKGROUND
Patients affected by pre-existing chronic spontaneous/Inducible urticaria (CSU/CIU) still feel unsafe due to the potential risk of an Adverse Event Following Immunization (AEFI) and Cutaneous Adverse Reactions (CARs) of COVID-19 vaccines. The appropriate management in this field remains debated and evidence is still lacking.
METHODS METHODS
We considered 160 CSU/CIU patients in Omalizumab/antihistamine therapy who received two doses of Comirnaty/Moderna mRNA vaccines; 20 of them also received a booster dose. Urticaria Activity Score-7 (UAS7) was used to assess the severity of the disease. Demographics, medical history, AEFI and CARs outcome after vaccination were collected by administering a web-based questionnaire completed by phone interview.
RESULTS RESULTS
In total, 147 patients did not show urticaria relapse (91.88%). Worsening cutaneous symptoms were experienced by 13 of our patients (8.12%). Exacerbation had a mean duration of 2 days and 11 h and mostly occurred after the first dose (69.23%). Systemic mild side effects were experienced by 9 patients (5.62%). No severe reactions were observed.
CONCLUSIONS CONCLUSIONS
Omalizumab can potentially prevent CARs and AEFI; however, major problems were registered during the 2-month stop period scheduled in the treatment. We suggest patients should not undergo vaccination during this period. CSU/CIU exacerbations appear to be transient and can be managed by antihistamines.

Identifiants

pubmed: 35407429
pii: jcm11071822
doi: 10.3390/jcm11071822
pmc: PMC8999670
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Dermatol Ther. 2021 Nov;34(6):e15153
pubmed: 34622531
J Am Acad Dermatol. 2021 Jul;85(1):46-55
pubmed: 33838206
Dermatol Ther. 2020 Jan;33(1):e13204
pubmed: 31863562
J Eur Acad Dermatol Venereol. 2022 Mar;36(3):e172-e174
pubmed: 34751995
MMWR Morb Mortal Wkly Rep. 2020 Dec 18;69(50):1922-1924
pubmed: 33332292
Allergy. 2022 Mar;77(3):734-766
pubmed: 34536239
Science. 2021 Mar 12;371(6534):1152-1153
pubmed: 33514629
J Control Release. 2021 May 10;333:511-520
pubmed: 33798667
Int J Dermatol. 2020 May;59(5):590-594
pubmed: 32048727
JAMA Dermatol. 2021 Aug 1;157(8):1000-1002
pubmed: 34160555
Allergy. 2021 Aug;76(8):2605-2607
pubmed: 33811344
N Engl J Med. 2020 Dec 31;383(27):2603-2615
pubmed: 33301246
Science. 2020 Mar 13;367(6483):1260-1263
pubmed: 32075877
Cureus. 2021 Sep 19;13(9):e18102
pubmed: 34692313
JAAD Case Rep. 2022 Jan 21;:
pubmed: 35079616
Clin Transl Allergy. 2015 Aug 17;5:29
pubmed: 26284152
J Eur Acad Dermatol Venereol. 2022 Feb;36(2):172-180
pubmed: 34661927
J Allergy Clin Immunol Pract. 2022 Mar;10(3):859-862
pubmed: 34979336
J Allergy Clin Immunol Pract. 2021 Jun;9(6):2195-2208
pubmed: 33823316
Immunotherapy. 2020 Nov;12(16):1173-1181
pubmed: 32892673
Allergol Select. 2021 Apr 1;5:140-147
pubmed: 33842829
N Engl J Med. 2021 Jan 7;384(1):80-82
pubmed: 33270381
J Am Acad Dermatol. 2018 Sep;79(3):567-569
pubmed: 29438758

Auteurs

Teresa Grieco (T)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Luca Ambrosio (L)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Federica Trovato (F)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Martina Vitiello (M)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Ilaria Demofonte (I)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Marta Fanto (M)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Giovanni Paolino (G)

Unità di Dermatologia, Ospedale San Raffaele, 20121 Milano, Italy.
Dermatologia Clinica, Università Vita-Salute San Raffaele, 20121 Milano, Italy.

Giovanni Pellacani (G)

Dermatology Unit, Sapienza University of Rome, 00185 Rome, Italy.

Classifications MeSH