Patients with rheumatologic diseases who developed a COVID-19 infection after vaccination were less likely to suffer long-term symptoms than unvaccinated but differently similar patients, the researchers said.
Among 280 patients with rheumatic diseases (most in the form of autoimmune arthritis or connective tissue disease) who survived acute COVID-19, 21% of other people vaccinated against the disease experienced symptoms for 90 days or more after the acute phase, with 41% of patients unvaccinated, according to Patel. MD, Massachusetts General Hospital in Boston, and colleagues.
When knowledge was adjusted for age, sex, race, comorbidities, and use of immunosuppressive medications, the chances of a vaccinated patient exhibiting symptoms of post-acute COVID, also known as “long COVID,” up to day 90 were one-tenth that number of unvaccinated patients (adjusted OR 0. 10, 95% CI: 0. 04-0. 22), the researchers wrote in a preprinted manuscript appearing on the medRxiv website.
Rates of post-acute symptoms over 28 days also decreased for vaccinated patients: 41% versus 54% (P = 0. 04), with an adjusted probability ratio of 0. 49 (95% CI 0. 29-0. 83).
“These findings suggest that, despite an increased threat of advanced infection, vaccinating patients with SARD [systemic autoimmune rheumatic diseases] reduces not only the threat of severe acute outcomes, but also long-term outcomes,” Patel and colleagues wrote.
But the organization also warned that vaccination is not a panacea for those patients. The onset of post-acute symptoms, they wrote, “remains common in SARD patients, even after vaccination, and when present, the severity is similar to that of unvaccinated or partially vaccinated persons. “
The 280 patients in the study were treated for COVID-19 from March 2020 to July 2022 at Boston’s Mass General Brigham system, whose medical records included billing codes for rheumatic diseases. Contacted after recovering from acute infection, they agreed to participate in a long-term follow-up study, which included questionnaires about aspects of their health. This study began in March 2021.
Only 60% of the entire organization had diagnoses of autoimmune arthritis, 24% had autoimmune connective tissue diseases, and 9% had some form of vasculitis. These diagnoses were well balanced between vaccinated (n=116) and unvaccinated (n=164) cohorts. .
However, there were vital differences between the groups. More in the vaccinated cohort used disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, mycophenolate mofetil, antimalarials, and biologics. Obesity in particular is not unusual in unvaccinated patients.
As is typical in systemic autoimmune diseases, 80% of both teams were women. The median age was 52 years and more than 80% were Caucasian.
About a portion of the unvaccinated organization had COVID-19 before February 2021, when vaccines were first widely available. After that, the peak of infections occurred in vaccinated patients (100 instead of 14). Only 4% of the vaccinated organization required hospitalization in comparison. 16% of the unvaccinated organization (hence the authors’ observation on reducing the threat of severe acute outcomes).
All 280 provided follow-up knowledge during the first 28 days after recovery from the acute phase; Data covering 90 days and more were available for 47 in the vaccinated organization and 159 in the unvaccinated organization.
Post-acute symptoms included pain, fatigue and functional difficulties. At the time of questionnaire completion (up to 20 four days after the acute phase), the median pain scores in the McGill Pain Short-Form tool were four in the vaccine organization compared to five for the unvaccinated (P = 0. 04). The median Fatigue Symptom Inventory scores were four8 in the vaccinated and five and five in the unvaccinated (P = 0. 08). Self-rated overall fitness prestige scores were also similar.
Participants were also asked to record days with and without symptoms, and these differed particularly between groups. In total, vaccinated patients assessed themselves without follow-up symptoms for an average of 138 days, compared with 109 days among unvaccinated patients, a difference of only about a month.
Limitations of the study included its reliance on participants’ self-reports, differences in major virus variants circulating over time and in the acute phase remedies used, and the imaginable confusion of SARD symptoms with those of post-acute COVID. In addition, the report gave the impression of being a pre-printed manuscript and therefore not subject to peer review.
John Gever, editor-in-chief from 2014 to 2021; He is now a normal contributor.
The study was funded through grants from NIH and nonprofit foundations. Two of the 15 authors reported extensive relationships with pharmaceutical companies. Others, Patel adding, reported having no relationships with commercial entities.