According to a press release from EULAR, severe COVID-19 infection and long COVID may be more prevalent among patients with rheumatic diseases compared with the general population. However, repeated vaccination may curtail severe and lingering disease. These new findings were presented by Boekel et al, Ørbo et al, and Andreoli et al at the EULAR 2023 Congress and simultaneously published in the Annals of the Rheumatic Diseases.
In the first study, researchers compared the risk of developing long COVID in 1,974 patients with rheumatic diseases and 733 controls. Among the patients who had been infected with COVID-19, 21% of those in the rheumatic disease group reported experiencing persistent symptoms for 8 weeks or more compared with 13% of those in the control group. The researchers utilized post-hoc modeling to demonstrate that patients with a higher body mass index who experienced greater COVID-19 disease severity were most likely to develop long COVID.
In the second study, investigators assessed the outcomes of 1,051 patients with immune-mediated inflammatory diseases taking immunosuppressive agents in order to determine whether postvaccination anti–spike protein antibody levels could serve as predictive measures of breakthrough COVID-19 infections. They found that patients who had higher levels of anti–spike protein antibodies experienced milder forms of COVID-19 infection and no mortality—highlighting the significance of repeated vaccination in this patient population.
In the third study, researchers analyzed the safety of COVID-19 vaccines in 92 patients with autoimmune diseases—40 of whom were pregnant and 52 of whom were breastfeeding. Among those who received the vaccines, 17.5% of patients who were pregnant, 20% of patients who were breastfeeding, and 18% of healthy controls experienced postvaccination flares. Although patients who were pregnant experienced more adverse events than the other study participants, the researchers highlighted that the benefits of receiving the vaccine may have outweighed the risks. The researchers also reported that their findings are reassuring, and they predict that the data may strengthen the physician-patient relationship to overcome vaccine hesitancy.