在SARS-CoV-2感染和接种疫苗后的新发系统性血管炎:触发因素,表型和结果
Prakashini Mv1, Akerke Auanassova2, Marlen Yessirkepov2
1Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India, 751024.
Clinical rheumatology
|July 8, 2023
概括
COVID-19 感染和疫苗可以引发系统性血管炎,一种影响血管的疾病. 这些COVID后或疫苗后的血管类型往往对类固醇治疗反应良好,并且可能自发消失.
科学领域:
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
背景情况:
- COVID-19 流行病带来了重大的医疗保健挑战,包括系统性血管炎等自身免疫并发症的出现.
- 无论是SARS-CoV-2感染还是接种疫苗,都与新发的系统性血管炎有关,影响各种血管大小.
研究的目的:
- 审查COVID-19及其疫苗对系统性血管炎的影响.
- 检查病毒或疫苗诱导的血管病变的过程和治疗方法.
- 探索免疫抑制对COVID-19疫苗免疫性的影响.
主要方法:
- 现有文献的叙述性审查.
- 对后COVID/疫苗血管炎的临床表现和自然史的分析.
- 评估治疗反应,特别是对皮质类固醇的反应.
主要成果:
- 与新型血管炎相比,病毒或疫苗诱导的血管炎呈现出不同的,往往更有利的过程,对类固醇有很好的反应.
- 没有证实SARS-CoV-2或疫苗接种引发可变血管血管炎 (例如,贝赫特病,川崎病) 的病例.
- 成年人COVID-19感染后的IgA血管炎与葡萄糖皮质类药物有着有利的结果.
- 免疫抑制,包括B细胞减弱剂,影响了疫苗的免疫性,但没有显著增加感染风险.
结论:
- 后COVID或疫苗后的血管类通常对普雷尼索隆 (0.8-1毫克/公斤) 有反应,逐渐逐渐减少.
- 免疫抑制和类固醇持续时间的治疗决定应该是个性化的.
- 需要进一步的研究才能充分了解长期影响和管理策略.
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