TY - JOUR

T1 - Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination

T2 - Results of the UCARE COVAC-CU study

AU - Kocatürk, Emek

AU - Salameh, Pascale

AU - Sarac, Esra

AU - Vera Ayala, Carolina E.

AU - Thomsen, Simon Francis

AU - Zuberbier, Torsten

AU - Ensina, Luis Felipe

AU - Popov, Todor A.

AU - van Doorn, Martijn B.A.

AU - Giménez-Arnau, Ana Maria

AU - Asero, Riccardo

AU - Criado, Paulo Ricardo

AU - Aarestrup, Fernando M.

AU - AbdulHameed Ansari, Zainab

AU - Al Abri, Salma

AU - Al Ahmad, Mona

AU - Al Hinai, Bushra

AU - Allenova, Anastasiia

AU - Al-Nesf, Maryam

AU - Altrichter, Sabine

AU - Arnaout, Rand

AU - Bartosińska, Joanna

AU - Bauer, Andrea

AU - Bernstein, Jonathan A.

AU - Bizjak, Mojca

AU - Bonnekoh, Hanna

AU - Bouillet, Laurence

AU - Brzoza, Zenon

AU - Calvalcanti Dela Bianca Melo, Ana Caroline

AU - Campinhos, Fernanda L.

AU - Carne, Emily

AU - Purayil, Saleema Cherichi

AU - Cherrez-Ojeda, Ivan

AU - Chong-Neto, Herberto Jose

AU - Christoff, George

AU - Conlon, Niall

AU - Jardim Criado, Roberta Fachini

AU - Cvenkel, Klara

AU - Damadoglu, Ebru

AU - Danilycheva, Inna

AU - Day, Cascia

AU - de Montjoye, Laurence

AU - Demir, Semra

AU - Ferucci, Silvia Mariel

AU - Fomina, Daria

AU - Fukunaga, Atsushi

AU - Garcia, Elizabeth

AU - Gelincik, Asli

AU - Göbel, Joe Hannah

AU - Godse, Kiran

AU - Gonçalo, Margarida

AU - Gotua, Maia

AU - Grattan, Clive

AU - Gugala, Agata

AU - Guillet, Carole

AU - Kalyoncu, Ali Fuat

AU - Karakaya, Gul

AU - Kasperska-Zając, Alicja

AU - Katelaris, Constance H.

AU - Khoshkhui, Maryam

AU - Kleinheinz, Andreas

AU - Kolacinska-Flont, Marta

AU - Kolkhir, Pavel

AU - Košnik, Mitja

AU - Krasowska, Dorota

AU - Kumaran, Muthu Sendhil

AU - Kuprys-Lipinska, Izabela

AU - Kurowski, Marcin

AU - Kuznetsova, Elizaveta V.

AU - Larenas-Linnemann, Désirée

AU - Lebedkina, Marina S.

AU - Lee, Youngsoo

AU - Makris, Michael P.

AU - Gómez, René Maximiliano

AU - Nasr, Iman

AU - Neisinger, Sophia

AU - Oda, Yoshiko

AU - Kara, Rabia Öztaş

AU - Palitot, Esther Bastos

AU - Papapostolou, Niki

AU - Salvador Parisi, Claudio Alberto

AU - Pesque, David

AU - Peter, Jonathan

AU - Petkova, Elena

AU - Ridge, Katie

AU - Rudenko, Michael

AU - Rutkowski, Krzysztof

AU - Saini, Sarbjit S.

AU - Salman, Andac

AU - Sanchez, Jorge

AU - Şekerel, Bülent

AU - Serdotetskova, Sofia A.

AU - Serpa, Faradiba S.

AU - Dikicier, Bahar Sevimli

AU - Sidiropoulos, Nikitas

AU - Sikora, Agnieszka

AU - Sørensen, Jennifer Astrup

AU - Soria, Angele

AU - Kucuk, Ozlem Su

AU - Thalappil, Sherin Rahim

AU - Tomaszewska, Katarzyna

AU - Tuncay, Gulseren

AU - Unal, Derya

AU - Valle, Solange

AU - van Lindonk, Esmee

AU - Vestergaard, Christian

AU - Vitchuk, Aleksandr

AU - Xepapadaki, Paraskevi

AU - Ye, Young Min

AU - Zalewska-Janowska, Anna

AU - Zamlynski, Mateusz

AU - Maurer, Marcus

N1 - Publisher Copyright: © 2023 American Academy of Allergy, Asthma & Immunology

PY - 2023

Y1 - 2023

N2 - Background: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy. 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.

AB - Background: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy. 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.

KW - Adverse effects

KW - COVID-19

KW - exacerbation

KW - omalizumab

KW - real life

KW - treatment

KW - urticaria

KW - vaccination

KW - vaccine

KW - worsening

U2 - 10.1016/j.jaci.2023.07.019

DO - 10.1016/j.jaci.2023.07.019

M3 - Journal article

C2 - 37574079

AN - SCOPUS:85171640167

VL - 152

SP - 1095

EP - 1106

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

IS - 5

ER -