Pediatric patients with autoimmune rheumatic diseases were found to have higher relapse rates after COVID-19 infection compared with after vaccination, according to study results published in Pediatric Rheumatology.
The clinical presentation and outcomes of COVID-19 have been shown to be milder among children than adults; however, data on the effect of COVID-19 specifically on pediatric autoimmune rheumatic diseases are limited.
In a single-center prospective study, researchers aimed to evaluate the rate of relapse among children with autoimmune rheumatic diseases after COVID-19 infection and vaccination.
Between March 2020 and April 2022, data on demographics, disease activity, clinical presentation, and serology were collected from patients in Sweden with autoimmune rheumatic diseases with COVID-19 infection and vaccination.
Relapse was defined as worsening of disease in 8 weeks after infection or vaccination.
A total of 115 patients with pediatric autoimmune rheumatic diseases were included in the study, of whom 92 had COVID-19 infection, 47 received vaccination, and 24 had both. All vaccinated patients received 2 doses of the Pfizer vaccine 3.7 (SD, 1.4) weeks apart. The most common diagnosis in both groups was juvenile idiopathic arthritis.
Results showed that the clinical presentation of COVID-19 infection was asymptomatic in 14 (14%) patients, mild in 69 (67%) and moderate in 19 (18%). One patient was hospitalized due to COVID-19-related infection and was unvaccinated.
Of 103 infections, 10 (10%) resulted in relapse of disease. The majority of relapses were of mild or moderate severity, with 1 case of severe relapse requiring hospitalization. The difference in relapse rate was not statistically significant (P =.76) between those who had COVID-19 infection and those who received vaccination.
Study limitations included the age differences (range, 2-23 years) among eligible participants and the study’s single-center design.
Overall, the study authors concluded, “There is a trend towards a higher relapse rate in [pediatric autoimmune rheumatic diseases] after infection compared to vaccination and connection between the severity of COVID-19 and vaccination status is plausible.”
This article originally appeared on Rheumatology Advisor
Savšek TS, Avramovič MZ, Avčin T, Korva M, Županc3 TA, Toplak N. Disease relapse rate in children with autoimmune rheumatic diseases after COVID-19 infection and vaccination. Pediatr Rheumatol. 2023;21:46. doi:10.1186/s12969-023-00829-4