Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Emek Kocatürk - , Koc University (Author)
  • Pascale Salameh - , Lebanese University (Author)
  • Esra Sarac - , Koc University (Author)
  • Carolina E Vera Ayala - , Leipzig University (Author)
  • Simon Francis Thomsen - , University of Copenhagen (Author)
  • Torsten Zuberbier - , Leipzig University (Author)
  • Luis Felipe Ensina - , Federal University of São Paulo (Author)
  • Todor A Popov - , University Hospital St Ivan Rilski (Author)
  • Martijn B A van Doorn - , Department of Dermatology (Author)
  • Ana Maria Giménez-Arnau - , Municipal Institute for Medical Research Hospital del Mar (Author)
  • Riccardo Asero - , Ospedale San Carlo, Potenza (Author)
  • Roberta Fachini Jardim Criado - , Alergoskin Alergia e Dermatologia (Author)
  • Fernando M Aarestrup - , Hospital Maternidade Therezinha de Jesus (Author)
  • Zainab AbdulHameed Ansari - , Royal Melbourne Hospital (Author)
  • Salma Al Abri - , Royal Melbourne Hospital (Author)
  • Mona Al-Ahmad - , Kuwait University (Author)
  • Bushra Al Hinai - , Royal Melbourne Hospital (Author)
  • Anastasiia Allenova - , M. V. Lomonosov Moscow State University (Author)
  • Maryam Al-Nesf - , Hamad Medical Corporation (Author)
  • Sabine Altrichter - , Kepler University Hospital (Author)
  • Rand Arnaout - , King Faisal Specialist Hospital and Research Centre (Author)
  • Joanna Bartosińska - , Medical University of Lublin (Author)
  • Andrea Bauer - , Department of Dermatology (Author)
  • Jonathan A Bernstein - , University of Cincinnati College of Medicine (Author)
  • Mojca Bizjak - , University Clinic of Respiratory and Allergic Diseases Golnik (Author)
  • Hanna Bonnekoh - , Leipzig University (Author)
  • Laurence Bouillet - , CHU de Grenoble (Author)
  • Zenon Brzoza - , Opole University of Technology (Author)
  • Ana Caroline Calvalcanti Dela Bianca Melo - , Hospital das Clinicas HCFMUSP (Author)
  • Fernanda L Campinhos - , Asthma Reference Center (Author)
  • Emily Carne - , Cardiff & Vale University Health Board (Author)
  • Saleema Cherichi Purayil - , Hamad Medical Corporation (Author)
  • Ivan Cherrez-Ojeda - , Hydrogen Research Department, Korea Institute of Energy Research (KIER) (Author)
  • Herberto Jose Chong-Neto - , Complexo Hospital de Clínicas (Author)
  • George Christoff - , Medical University Sofia (Author)
  • Niall Conlon - , Trinity College Dublin (Author)
  • Roberta Fachini Jardim Criado - , Alergoskin Alergia e Dermatologia (Author)
  • Klara Cvenkel - , University Medical Centre Ljubljana (Author)
  • Ebru Damadoglu - , Hacettepe University School of Medicine (Author)
  • Inna Danilycheva - , NRC Institute of Immunology FMBA of Russia (Author)
  • Cascia Day - , University of Cape Town (Author)
  • Laurence de Montjoye - , Department of Dermatology (Author)
  • Semra Demir - , Istanbul University Cerrahpaşa (Author)
  • Silvia Mariel Ferucci - , Department of Dermatology (Author)
  • Daria Fomina - , Astana Medical University (Author)
  • Atsushi Fukunaga - , Osaka Medical and Pharmaceutical University (Author)
  • Elizabeth Garcia - , Universidad de los Andes Colombia (Author)
  • Asli Gelincik - , Istanbul University Cerrahpaşa (Author)
  • Joe Hannah Göbel - , Leipzig University (Author)
  • Kiran Godse - , Dr. D.Y. Patil Medical College & Hospital (Author)
  • Margarida Gonçalo - , University of Coimbra (Author)
  • Maia Gotua - , David Tvildiani Medical University (Author)
  • Clive Grattan - , St. Thomas' Hospital (Author)
  • Agata Gugala - , Medical University of Łódź (Author)
  • Carole Guillet - , University Hospital Zurich (Author)
  • Ali Fuat Kalyoncu - , Hacettepe University School of Medicine (Author)
  • Gul Karakaya - , Hacettepe University School of Medicine (Author)
  • Alicja Kasperska-Zając - , Medical University of Silesia in Katowice (Author)
  • Constance H Katelaris - , University of Western Sydney and Campbelltown Hospital (Author)
  • Maryam Khoshkhui - , Mashhad University of Medical Sciences (Author)
  • Andreas Kleinheinz - , Department of Dermatology (Author)
  • Marta Kolacinska-Flont - , Medical University of Łódź (Author)
  • Pavel Kolkhir - , Leipzig University (Author)
  • Mitja Košnik - , University Clinic of Respiratory and Allergic Diseases Golnik (Author)
  • Dorota Krasowska - , Medical University of Lublin (Author)
  • Muthu Sendhil Kumaran - , Postgraduate Institute of Medical Education and Research (Author)
  • Izabela Kuprys-Lipinska - , Medical University of Łódź (Author)
  • Marcin Kurowski - , Medical University of Łódź (Author)
  • Elizaveta V Kuznetsova - , Sechenow First Moscow State Medical University (Author)
  • Désirée Larenas-Linnemann - , Hospital Médica Sur (Author)
  • Marina S Lebedkina - , Moscow City Research and Practical Center of Allergoloy and Immunology (Author)
  • Youngsoo Lee - , Ajou University Graduate School of Medicine (Author)
  • Michael Makris - , University Hospital "Attikon" (Author)
  • René Maximiliano Gómez - , Catholic University of Salta (Author)
  • Iman Nasr - , Royal Melbourne Hospital (Author)
  • Sophia Neisinger - , Leipzig University (Author)
  • Yoshiko Oda - , Kobe University (Author)
  • Rabia Öztaş Kara - , University of Sakarya School of Medicine (Author)
  • Esther Bastos Palitot - , Federal University of Paraiba (Author)
  • Niki Papapostolou - , University Hospital "Attikon" (Author)
  • Claudio Alberto Salvador Parisi - , Adult and Pediatric Allergy Sections of the Italian Hospital of Buenos Aires (Author)
  • David Pesque - , Municipal Institute for Medical Research Hospital del Mar (Author)
  • Jonathan Peter - , University of Cape Town (Author)
  • Elena Petkova - , Medical University Sofia (Author)
  • Katie Ridge - , Trinity College Dublin (Author)
  • Michael Rudenko - , The London Allergy & Immunology Centre (Author)
  • Krzysztof Rutkowski - , St John's Institute of Dermatology (Author)
  • Sarbjit S Saini - , Johns Hopkins Asthma and Allergy Center (Author)
  • Andac Salman - , Marmara University School of Medicine (Author)
  • Jorge Sanchez - , University of Antioquia (Author)
  • Bülent Şekerel - , Hacettepe University (Author)
  • Sofia A Serdotetskova - , Moscow City Research and Practical Center of Allergoloy and Immunology (Author)
  • Faradiba S Serpa - , Asthma Reference Center (Author)
  • Bahar Sevimli Dikicier - , University of Sakarya School of Medicine (Author)
  • Nikitas Sidiropoulos - , University Hospital "Attikon" (Author)
  • Agnieszka Sikora - , Medical University of Silesia in Katowice (Author)
  • Jennifer Astrup Sørensen - , University of Copenhagen (Author)
  • Angele Soria - , Tenon Hospital APHP (Author)
  • Ozlem Su Kucuk - , Bezmialem Vakif University School of Medicine (Author)
  • Sherin Rahim Thalappil - , Hamad Medical Corporation (Author)
  • Katarzyna Tomaszewska - , Medical University of Łódź (Author)
  • Gulseren Tuncay - , Hacettepe University School of Medicine (Author)
  • Derya Unal - , Istanbul University Cerrahpaşa (Author)
  • Solange Valle - , Universidade Federal do Rio de Janeiro (Author)
  • Esmee van Lindonk - , Department of Dermatology (Author)
  • Christian Vestergaard - , Aarhus University Hospital (AUH) (Author)
  • Raisa Y Meshkova - , Smolensk State University (Author)
  • Aleksandr Vitchuk - , Smolensk State University (Author)
  • Paraskevi Xepapadaki - , National and Kapodistrian University of Athens (Author)
  • Young-Min Ye - , Ajou University Graduate School of Medicine (Author)
  • Anna Zalewska-Janowska - , Medical University of Łódź (Author)
  • Mateusz Zamlynski - , Medical University of Silesia in Katowice (Author)
  • Marcus Maurer - , Leipzig University (Author)

Abstract

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.

Details

Original languageEnglish
Pages (from-to)1095-1106
Number of pages12
JournalJournal of Allergy and Clinical Immunology
Volume152
Issue number5
Publication statusPublished - Nov 2023
Peer-reviewedYes

External IDs

ORCID /0000-0002-4411-3088/work/148145505
Scopus 85171640167

Keywords

Sustainable Development Goals

Keywords

  • Humans, Female, Adolescent, Adult, COVID-19 Vaccines/adverse effects, COVID-19/prevention & control, Retrospective Studies, Urticaria/drug therapy, Chronic Urticaria, Vaccination/adverse effects