Rheumatoid Arthritis Flare-ups Following Immunization with Sinopharm Inactivated Virus-based COVID-19 Vaccine

• Published in: Majallah-i ṭibb-i ūrzhāns-i Īrān = Iranian journal of emergency medicine : faṣlnāmah-i rasmī-i Dipārtimān-i Ṭibb-i Ūrzhāns-i Dānishgāh-i ʻUlūm-i Pizishkī-i Shahīd Bihishtī Vol. 10; no. 1
• Main Authors: Parisa Delkash, Amir Azimi, Niloufar Taherpour, Alireza Rajaei, Faraneh Farsad, Saeid Haji Aghajani
• Format: Journal Article
• Language: English
• Published: Shahid Beheshti University of Medical Sciences 01.08.2023
• Subjects: COVID-19; Flare-ups; Rheumatoid arthritis; Sinopharm
• ISSN: 2383-3645
• DOI: 10.22037/ijem.v10i1.42970

Introduction: This study aimed to investigate the incidence of rheumatoid arthritis (RA) flare-ups following immunization with the Sinopharm COVID-19 inactivated virus-based vaccine. Methods: We conducted a retrospective observational study at the Rheumatology Clinic of Imam Hossein Hospital, incorporating 200 RA patients in remission undergoing non-biologic Disease-Modifying Antirheumatic Drugs (DMARDs) treatments. A rheumatologist confirmed a flare-up based on patients complain of arthralgia and joint stiffness and complete examination of joints over a three-month period following vaccination. Results: Twelve percent of all included patients experienced symptom recurrence. The average age of patients with flare-ups was significantly higher, but no gender-based differences were observed (p<0.001 and p=0.071, respectively). The second vaccine dose resulted in a higher number of symptom flares compared to the first dose (9.30% vs. 3.0%, p < 0.001). No significant differences were observed between patients experiencing flare-ups after the first dose and the second dose in terms of the number of involved joints (p=0.321) and the time gap from vaccination to symptom recurrence (p=0.526). No patients required hospitalization, and prednisolone dosage adjustments effectively managed symptoms. Conclusion: The occurrence of flare-ups was relatively low after the Sinopharm COVID-19 vaccination in RA patients undergoing treatment with DMARDs during remission. The majority of these flares were mild and no hospitalizations were required.