Rates and Symptoms of Post-Acute COVID-19 Similar Among Patients With ARDs and General Public

No significant association was found between immune/inflammatory autoimmune rheumatic diseases (ARDs) and post-acute COVID-19 following a third COVID-19 vaccine dose, according to study results published in Advances in Rheumatology.

Investigators in Brazil sought to characterize post-acute COVID-19 in patients with SARS-CoV-2 infection and comorbid ARDs who had been immunized with the CoronaVac vaccine.

Investigators used data from a prospective cohort (ClinicalTrials.gov Identifier: NCT04754698) to conduct a retrospective evaluation that included patients with and without (control group) ARDs diagnosed with SARS-CoV-2 infection following their third CoronaVac vaccine dose.

Patients were contacted 5 months after their third vaccine dose and assessed for post-acute COVID-19 symptoms. Post-acute COVID-19 was defined as occurrence of new symptoms or persistence of pre-existing symptoms lasting 4 weeks or longer, following onset of SARS-CoV-2 infection.

A total of 108 patients with ARDs and 32 patients in the control group reported having COVID-19 and were included in the analysis.

Investigators found that patients with ARDs vs the control group had comparable frequencies of post-acute COVID-19, among those with at least 4 weeks post-acute COVID-19 (58.3% vs 53.1%; P =.6854) and greater than 12 weeks post-acute COVID-19 (39.8% vs 46.9%; P =.5419), respectively.

Frequencies for predominance of reporting 3 or more symptoms were similar among patients with ARDs vs the control group among those with at least 4 weeks post-acute COVID-19 (54.0% vs 41.2%; P =.7886) and those with greater than 12 weeks post-acute COVID-19 (68.3% vs 88.2%; P =.1322), respectively.

Investigators noted frequency of post-acute COVID-19 in patients with ARDs was greater than 50% for all analyzed diseases, with the exception of primary Sjögren’s syndrome (40%). The highest frequencies were found among patients with primary antiphospholipid syndrome (75%; 3/4 patients) and systemic sclerosis (100%; 6/6 patients).

Sex, age, reinfection, autoimmune diseases, and severity of COVID-19 were not associated risk factors among patients with ARDs with at least 4 weeks post-acute COVID-19 (P >.05).

Investigators found no association between specific ARDs and post-acute COVID-19, except among 6 patients with systemic sclerosis who developed post-acute COVID-19 (9.5%; P =.0398). There were no significant between-group differences in clinical manifestations of post-acute COVID-19 (P >.05), and the most frequent manifestations included memory loss, fatigue, hair loss, and mood swings.

Study limitations included use of a convenience sample and a nonvalidated instrument to assess mental health, preventing analysis of anxiety and depression.

“This data is an encouragement for rheumatologists, but it is a huge challenge for those who follow these ARD patients considering the great overlap of manifestations between

the two conditions and that most of them will evolve to longer post-acute COVID-19 condition.”