Presenter of 2 Presentations
O014 - SYSTEMIC VASCULITIDES DURING COVID-19 PANDEMIC (ID 8)
Abstract
Background and Aims
COVID-19 pandemic affected our management of systemic vasculitides. To provide the best care, daily practice has had to be adjusted. We aimed to evaluate how successful we were in the management of systemic vasculitides during pandemic.
Methods
We analysed medical records of adult patients diagnosed with a systemic vasculitis before (Jan/2010-Feb/2020; overall 122 months) and during COVID-19 pandemic (Mar/2020 – Sep/2021; overall 19 months) at our secondary/tertiary medical centre. Variations in the frequency, delays to diagnosis (symptom duration time until diagnosis) and the baseline activity of the most commonly diagnosed vasculitides, i.e. GCA, IgA vasculitis, AAV and cryoglobulinemic vasculitis (CryoV) were recorded. Disease activity/severity was assessed by the BVAS (version 3) for small vessel vasculitides, and by assessing the development of permanent ischemic complications (permanent vision defect and/or ischemic stroke) in GCA.
Results
During the pandemic period, we diagnosed 122 new cases of GCA, IgAV, AAV, and CryoV (51, 33, 32, and 6 cases, respectively). Whereas the frequency per year of new GCA, IgAV and CryoV cases was comparable to pre-pandemic period, we diagnosed AAV nearly 3-times more frequently during the pandemic compared to average pre-pandemic year. Table 1 shows the median (IQR) symptom duration time and disease activity at presentation. In spite of the COVID-19 pandemic, neither was the symptom duration time longer nor was the baseline disease activity higher compared to the pre-pandemic decade.
Conclusions
The frequency of AAV increased during COVID-19 pandemic. Despite a lockdown during pandemic, we did not record any significant delay in diagnosing systemic vasculitides.
O043 - IMMUNE MEDIATED EVENTS TIMELY ASSOCIATED WITH COVID-19 VACCINE (ID 23)
Abstract
Background and Aims
Vaccination may induce de novo autoimmune disease, particularly in genetically predisposed individual. We aimed to study cases of new onset immune mediated disease temporally associated with COVID-19 vaccination.
Methods
We analyzed medical records of patients that presented to our secondary/tertiary rheumatology center with rheumatic symptoms developing in association with COVID-19 vaccination.
Results
By the Aug/2021, around 361,000 residents in our region received at least one dose of COVID-19 vaccines available in the country (Pfizer-BioNTech and Moderna, Oxford/AstraZeneca and Jannsen/Johnson&Johnson). During the same period, we identified 28 adults in whom the onset of (auto)immune disease was timely associated with vaccination. Vasculitis was the most prevalent (9 cases), followed by polymyalgia rheumatica, skin panniculitis and neuromuscular disorders. (Table 1) Patients developed symptoms with a median (IQR) delay of 10 (7 – 18) days after either partial (12 cases), or full (16 cases) vaccination. Interestingly, two patients recovered 6 months prior to vaccination from COVID-19, and another one finished a full vaccination during proven COVID-19. Three patients had a history of rheumatic disease, that was in complete remission at the time of vaccination. Overall, 25 patients received systemic treatment (glucocorticoids 23; NSAID 1; anticoagulants 4; DMARD 2), two local treatment (surgery 1, local steroids 1), and one patient received no treatment.
Conclusions
COVID-19 vaccines should be considered as a risk factor for inducing autoimmune and autoinflammatory phenomena.