Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study.
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Kocatürk Emek, Salameh Pascale, Sarac Esra, Vera Ayala Carolina E, Thomsen Simon Francis, Zuberbier Torsten, Ensina Luis Felipe, Popov Todor A, van Doorn Martijn B A, Giménez-Arnau Ana Maria, Asero Riccardo, Criado Paulo Ricardo, Aarestrup Fernando M, AbdulHameed Ansari Zainab, Al Abri Salma, Al-Ahmad Mona, Al Hinai Bushra, Allenova Anastasiia, Al-Nesf Maryam, Altrichter Sabine, Arnaout Rand, Bartosińska Joanna, Bauer Andrea, Bernstein Jonathan A, Bizjak Mojca, Bonnekoh Hanna, Bouillet Laurence, Brzoza Zenon, Calvalcanti Dela Bianca Melo Ana Caroline, Campinhos Fernanda L, Carne Emily, Purayil Saleema Cherichi, Cherrez-Ojeda Ivan, Chong-Neto Herberto Jose, Christoff George, Conlon Niall, Jardim Criado Roberta Fachini, Cvenkel Klara, Damadoglu Ebru, Danilycheva Inna, Day Cascia, de Montjoye Laurence, Demir Semra, Ferucci Silvia Mariel, Fomina Daria, Fukunaga Atsushi, Garcia Elizabeth, Gelincik Asli, Göbel Joe Hannah, Godse Kiran, Gonçalo Margarida, Gotua Maia, Grattan Clive, Gugala Agata, Guillet Carole, Kalyoncu Ali Fuat, Karakaya Gul, Kasperska-Zając Alicja, Katelaris Constance H, Khoshkhui Maryam, Kleinheinz Andreas, Kolacinska-Flont Marta, Kolkhir Pavel, Košnik Mitja, Krasowska Dorota, Kumaran Muthu Sendhil, Kuprys-Lipinska Izabela, Kurowski Marcin, Kuznetsova Elizaveta V, Larenas-Linnemann Désirée, Lebedkina Marina S, Lee Youngsoo, Makris Michael, Gómez René Maximiliano, Nasr Iman, Neisinger Sophia, Oda Yoshiko, Kara Rabia Öztaş, Palitot Esther Bastos, Papapostolou Niki, Salvador Parisi Claudio Alberto, Pesque David, Peter Jonathan, Petkova Elena, Ridge Katie, Rudenko Michael, Rutkowski Krzysztof, Saini Sarbjit S, Salman Andac, Sanchez Jorge, Şekerel Bülent, Serdotetskova Sofia A, Serpa Faradiba S, Dikicier Bahar Sevimli, Sidiropoulos Nikitas, Sikora Agnieszka, Sørensen Jennifer Astrup, Soria Angele, Kucuk Ozlem Su, Thalappil Sherin Rahim, Tomaszewska Katarzyna, Tuncay Gulseren, Unal Derya, Valle Solange, van Lindonk Esmee, Vestergaard Christian, Meshkova Raisa Y, Vitchuk Aleksandr, Xepapadaki Paraskevi, Ye Young-Min, Zalewska-Janowska Anna, Zamlynski Mateusz, Maurer Marcus
Аннотация
OBJECTIVE: We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination.
METHODS: COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged ≥18 years and vaccinated with ≥1 dose of any COVID-19 vaccine. We evaluated CU exacerbations and severe allergic reactions as well as other adverse events associated with COVID-19 vaccinations and their association with various CU parameters.
RESULTS: Across 2769 COVID-19-vaccinated CU patients, most (90%) received at least 2 COVID-19 vaccine doses, and most patients received CU treatment and had well-controlled disease. The rate of COVID-19 vaccination-induced CU exacerbation was 9%. Of 223 patients with CU exacerbation after the first dose, 53.4% experienced recurrence of CU exacerbation after the second dose. CU exacerbation most often started <48 hours after vaccination (59.2%), lasted for a few weeks or less (70%), and was treated mainly with antihistamines (70.3%). Factors that increased the risk for COVID-19 vaccination-induced CU exacerbation included female sex, disease duration shorter than 24 months, having chronic spontaneous versus inducible urticaria, receipt of adenovirus viral vector vaccine, having nonsteroidal anti-inflammatory drug/aspirin intolerance, and having concerns about getting vaccinated; receiving omalizumab treatment and Latino/Hispanic ethnicity lowered the risk. First-dose vaccine-related adverse effects, most commonly local reactions, fever, fatigue, and muscle pain, were reported by 43.5% of CU patients. Seven patients reported severe allergic reactions.
CONCLUSIONS: COVID-19 vaccination leads to disease exacerbation in only a small number of CU patients and is generally well tolerated.