Vaccinated patients with SARDs less likely to exhibit lingering COVID-19 symptoms
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Patients with systemic autoimmune rheumatic diseases who are fully vaccinated against COVID-19 are less likely to experience long COVID symptoms, compared with unvaccinated patients, according to data.
“This study came out of our prospective cohort of patients with rheumatic diseases and COVID-19 in whom we assessed clinical COVID-19 course as well as multiple patient-reported outcomes,” Naomi Patel, MD, of the division of rheumatology, allergy and immunology at Massachusetts General Hospital, told Healio.
“Much of our group’s prior work has focused on the severity of the acute course of COVID-19,” Patel added. “As the focus for many now shifts to and incorporates the longer-term manifestations of COVID-19, this is an area in which there is little-to-no data in those with rheumatic diseases.”
To study the impact of COVID-19 vaccination on long COVID symptoms in patients with systemic autoimmune rheumatic diseases (SARDs), Patel and colleagues conducted a prospective study within the Mass General Brigham hospital system. They identified patients in the hospital system with SARDs who had a positive COVID-19 test result between March 1, 2020, and July 8, 2022. Those who survived their acute infection were invited to participate through an initial invitation on March 11, 2021, and on a rolling basis afterward.
The variable of interest for researchers was the vaccination status. Patients were recorded as being fully vaccinated, partially vaccinated or unvaccinated at the onset of COVID-19 infection. The primary outcome was the presence of post-acute sequelae of COVID-19. This was defined as any persistent symptom that remained present at 28 days post-infection. Additionally, the researchers analyzed post-acute sequelae at 90 days following infection as a secondary endpoint. Other outcomes included pain, fatigue and functional status scores.
The analysis included a total of 280 patients, of whom 11% were unvaccinated, 48% were partially vaccinated and 41% were fully vaccinated. The SARDs represented most often were inflammatory arthritis, in 59% of those included, and connective tissue disease, which present in 24% of included patients. There were 116 breakthrough COVID-19 infections among vaccinated patients, and 164 non-breakthrough cases.
According to the researchers, who published their findings in the Annals of the Rheumatic Diseases, patients who were vaccinated and developed breakthrough infections demonstrated more symptom-free days throughout the follow-up period (+21.4days; 95%CI, 0.95 to 41.91). Additionally, patients who were vaccinated demonstrated lower odds of post-acute sequelae at 28 days (adjusted OR = 0.49; 95% CI, 0.29-0.83) and 90 days (adjusted OR = 0.1; 95% CI, 0.04-0.22).
“Among those who did develop post-acute sequelae, the overall severity was similar among those with and without a breakthrough infection, though people vaccinated prior to infection had less pain and fatigue following infection,” Patel said. “These findings reinforce the importance of vaccination in patients with rheumatic diseases. Future studies could evaluate differences in post-acute sequelae by vaccination status during the time in which a single variant is predominant to better assess this question.”
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