Background/Purpose: From January 2021 around 60% of the total population has received at least one dose of any COVID-19 vaccine. A minority of vaccinated individuals present autoimmune phenomenon which can be presented in individuals with previous autoimmune diseases or as new onset manifestations. The aim of this research is to establish the frequency of new onset rheumatological syndromes associated to COVID-19 vaccination.

Methods: Systematic search for original research articles published between January 2021 and April 2022 was formulated. The search process was carried out following the PRISMA guidelines. Electronic searches were performed in Medline, EMBASE, Cochrane, Scopus, EBSCO, WoS and LILACS using the following key terms in all possible combinations: “Rheumatic diseases”, “Systemic Vasculitis”, “Myositis”, “Polymyositis”, “Lupus Erythematosus, Systemic”, “Antiphospholipid Syndrome”, “Still’s Disease, Adult-Onset”, “Rheumatoid arthritis”, “ANCA-associated vasculitis”, “Spondylarthritis”, “Reactive arthritis”, “Sjogren’s syndrome”, “Systemic sclerosis”, “Covid-19 vaccine” and “SARS-CoV-2 vaccine”. Cohort studies, case reports or case series were included if the patients fulfilled the specific diagnostic/classification criteria and/or nomenclature for each rheumatic autoimmune disease. Publications were excluded if they did not fulfill the above criteria.

Results: The electronic search yielded 271 publications. A total of 157 articles were evaluated and 51 reports with 72 patients (GCA 6, IgA vasculitis 6, SLE 10, ANCA vasculitis 23, adult-onset Still’s disease 9, reactive arthritis 2, rheumatoid arthritis 3, Sjögren’s syndrome 3, systemic sclerosis 2, Takayasu’s arteritis 2, cryoglobulinemic vasculitis 1, Kawasaki disease 3, Polymyalgia rheumatica 2) were included. 54.8% were men with a median age of 56 years (IQR 6.5-14 y/o), 41.7% developed rheumatic disease after the first dose and 36% after the second dose, with a median of 10 days (IQR 6.5-14 days). 70.8% received corticosteroids (18.1% High-dose and 20.8% Pulse), 40.3% received immunosuppressant (cyclophosphamide 11.1%, rituximab 4.2, hydroxychloroquine 6.9, methotrexate 5.6, tocilizumab 4.2, mycophenolate 4.2, immunoglobulin 11.1 y 4.2% others). The 54.2% had complete remission, 20.8% partial and 9.7% non-response.

Conclusion: Despite the increasing number of documented cases, the incidence remains low compared to the benefits of vaccination.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/new-onset-rheumatologic-syndromes-after-covid-19-vaccination-systematic-review/