Investigation of COVID-19 Vaccination and Disease Status in Behçet’s Patients

Abstract

Objectives: Behçet’s disease is a vasculitis of unknown cause that can affect many systems, especially the skin, mucosa, joint and eyes. In this study, coronavirus disease-2019 (COVID-19) and vaccination status in Behçet’s patients were examined. The relationship between the characteristics of Behçet’s patients and the data related to COVID-19 was investigated. Materials and Methods: Three hundred and three Behçet’s patients were randomly included in this study. The vaccination status of the patients and the type of COVID-19 vaccine administered were questioned. Whether the patients had COVID-19 and the disease process were examined. Behçet’s patients with a positive COVID-19 polymerase chain reaction (PCR) test were considered to have had the disease. Results: The mean age was 46.3 (±12.3) years, 40.6% were male, and the age at diagnosis was 30.4 (±9.1) years. COVID-19 PCR test positivity was detected in 132 (43.5%) of the patients. It was observed that 72% (n=95) of the patients with test positivity were symptomatic and the hospitalization rate was 3%. It was observed that Behçet’s patients who had COVID-19 had less central nervous system involvement than those who did not (p=0.01). No significant correlation was found between other clinical manifestations of Behçet’s disease, age, gender, and the age at diagnosis of the disease, and the history of having COVID-19. The rate of COVID-19 vaccination in Behçet’s patients was 92.1% for the first dose, 89.4% for the second dose, and 60% for the third dose. It was observed that the Biontech vaccine was administered more frequently than other types of vaccines. It was detected that the number of COVID-19 vaccinations was significantly higher in the group that did not have COVID-19 (p=0.003). Conclusion: In this study, although the rate of COVID-19 disease was high in Behçet’s patients, the rate of hospitalization was low. The importance of COVID-19 vaccination was emphasized. Key Words: Behçet’s Disease, Vasculitis, COVID-19, Vaccination

Keywords

• Behçet’s Disease
• Vasculitis
• COVID-19
• Vaccination

Behçet Hastaları’nda COVID-19 Aşılaması ve Hastalık Geçirme Durumunun İncelenmesi

Abstract

Amaç: Behçet hastalığı deri, mukoza, eklem ve göz başta olmak üzere birçok sistemi tutabilen, nedeni bilinmeyen bir vaskülittir. Bu çalışmada Behçet hastalarında koronavirüs hastalığı-2019 (COVID-19) ve aşılama durumu incelendi. Behçet hastalarına ait özelliklerin, COVID-19 ile ilgili verilerle olan ilişkisi sorgulandı. Gereç ve Yöntem: Bu çalışmaya 303 Behçet hastası rastgele bir şekilde dahil edildi. Hastaların aşılanma durumu ve yapılan COVID-19 aşısının türü sorgulandı. COVID-19 geçirip geçirmediği ve hastalığın nasıl seyrettiği incelendi. COVID-19 polimeraz zincir reaksiyonu (PCR) testi pozitif olan Behçet hastaları, hastalığı geçirmiş olarak kabul edildi. Bulgular: Behçet hastalarının %40,6’sı erkek, yaş ortalaması 46,3 (±12,3), hastalık tanı yaşı 30,4 (±9,1) yıl olarak saptandı. Hastaların 132’sinde (%43,5) COVID-19 PCR testi pozitifliği tespit edildi. Test pozitifliği olan hastaların %72’sinin (n=95) semptomatik seyrettiği ve hastaneye yatış oranının %3 olduğu görüldü. COVID-19 geçiren Behçet hastalarında, geçirmeyenlere göre daha az oranda santral sinir sistemi tutulumu olduğu görüldü (p=0,01) Behçet hastalığının diğer klinik tutulumları, yaş, cinsiyet ve hastalık tanı yaşı ile COVID-19 geçirme öyküsü arasında anlamlı ilişki saptanmadı. Behçet hastalarında COVID-19 aşılamasında 1. doz aşı oranı %92,1, 2. doz için %89,4, 3. doz için %60 saptandı. Biontech aşısının diğer aşı türlerine göre daha sık oranda yapıldığı görüldü. COVID-19 aşılama sayısının, COVID-19 geçirmeyen grupta anlamlı olarak daha fazla olduğu tespit edildi (p=0,003). Sonuç: Bu çalışmada Behçet hastalarında COVID-19 hastalığı oranı yüksek olsa da hastaneye yatış oranı düşük görüldü. COVID-19 aşılamasının önemi vurgulandı. Anahtar Kelimeler: Behçet Hastalığı, Vaskülit, COVID-19, Aşılama

Keywords

• Behçet Hastalığı
• Vaskülit
• COVID-19
• Aşılama

References

1. 1. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-1062.
2. 2. Maddur MS, Vani J, Lacroix-Desmazes S, et al. Autoimmunity as a predisposition for infectious diseases. PLoS Pathog. 2010;6:e1001077.
3. 3. Grainger R, Kim AHJ, Conway R, et al. COVID-19 in people with rheumatic diseases: risks, outcomes, treatment considerations. Nat Rev Rheumatol. 2022;18:191-204.
4. 4. Baden LR, El Sahly HM, Essink B, et al. Efficacy and Safety of the mRNA- 1273 SARS-CoV-2 Vaccine. N Engl J Med. 2021;384:403-416.
5. 5. Tanriover MD, Doğanay HL, Akova M, et al. Efficacy and safety of an inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac): interim results of a double-blind, randomised, placebo-controlled, phase 3 trial in Turkey. Lancet. 2021;398:213-222.
6. 6. Yazici Y, Hatemi G, Bodaghi B, et al. Behçet syndrome. Nat Rev Dis Primers. 2021;7:67.
7. 7. Shahram F, Esalatmanesh K, Khabbazi A, et al. Coronavirus disease 2019 in patients with Behcet’s disease: a report of 59 cases in Iran. Clin Rheumatol. 2022;41:1177-1183.
8. 8. Ozdede A, Guner S, Ozcifci G, et al. Safety of SARS-CoV-2 vaccination in patients with Behcet’s syndrome and familial Mediterranean fever: a crosssectional comparative study on the effects of M-RNA based and inactivated vaccine. Rheumatol Int. 2022;42:973-987.

9. 9. Criteria for diagnosis of Behçet’s disease. International Study Group for Behçet’s Disease. Lancet. 1990;335:1078-1080.
10. 10. Gandhi RT, Lynch JB, Del Rio C. Mild or Moderate Covid-19. N Engl J Med. 2020;383:1757-1766.
11. 11. Yurttaş B, Oztas M, Tunc A, et al. Characteristics and outcomes of Behçet’s syndrome patients with Coronavirus Disease 2019: a case series of 10 patients. Intern Emerg Med. 2020;15:1567-1571.
12. 12. Polat B, Erden A, Güven SC, et al. COVID-19 in patients with Behçet’s disease: Outcomes and rate of Behçet’s exacerbations in a retrospective cohort. Mod Rheumatol. 2022;32:455-459.
13. 13. Ozcifci G, Aydin T, Atli Z, et al. The incidence, clinical characteristics, and outcome of COVID-19 in a prospectively followed cohort of patients with Behçet’s syndrome. Rheumatol Int. 2022;42:101-113.
14. 14. Pakhchanian H, Raiker R, Kardeş S. COVID-19 among patients with Behçet syndrome in the United States. Clin Rheumatol. 2022;41:317-331.
15. 15. Oztas M, Bektas M, Karacan I, et al. Frequency and severity of COVID-19 in patients with various rheumatic diseases treated regularly with colchicine or hydroxychloroquine. J Med Virol. 2022;94:3431-3437.
16. 16. Papagoras C, Fragoulis GE, Zioga N, et al. Better outcomes of COVID-19 in vaccinated compared to unvaccinated patients with systemic rheumatic diseases. Ann Rheum Dis. 2022;81:1013-1016.
17. 17. Tang KT, Hsu BC, Chen DY. Immunogenicity, Effectiveness, and Safety of COVID-19 Vaccines in Rheumatic Patients: An Updated Systematic Review and Meta-Analysis. Biomedicines. 2022;10:834.
18. 18. Apaydin H, Erden A, Güven SC, et al. Effects of anti-SARS-CoV-2 vaccination on safety and disease exacerbation in patients with Behçet syndrome in a monocentric cohort. Int J Rheum Dis. 2022;25:1068-1077.
19. 19. https://covid19asi.saglik.gov.tr.
20. 20. Ozdede A, Nohut OK, Atli Z, et al. Higher antibody responses after mRNAbased vaccine compared to inactivated vaccine against SARS-CoV-2 in Behcet’s syndrome. Rheumatol Int. 2022;42:1741-1750.