Abstract
Newly emerging variants of coronavirus 2 (SARS-CoV-2) raise concerns about the spread of the disease, and with the rising case numbers, the Coronavirus disease 2019 (COVID-19) remains a challenging medical emergency towards the end of the year 2021. Swiftly developed novel vaccines aid in the prevention of the spread, and it seems that a specific cure will not be at hand soon. The prognosis of COVID-19 in patients with autoimmune/autoinflammatory rheumatic diseases (AIIRD) is more severe when compared to the otherwise healthy population, and vaccination is essential. Evidence for both the efficacy and safety of COVID-19 vaccination in AIIRD under immunosuppression is accumulating, but the effect of Interleukin-1 on vaccination in general and in AIIRD patients is rarely addressed in the current literature. In light of the current literature, it seems that the level of agreement on the timing of COVID-19 vaccination is moderate in patients using IL-1 blockers, and expert opinions may vary. Generally, it may be recommended that patients under IL-1 blockade can be vaccinated without interrupting the anti-cytokine therapy, especially in patients with ongoing high disease activity to avoid disease relapses. However, in selected cases, after balancing for disease activity and risk of relapses, vaccination may be given seven days after the drug levels have returned to baseline, especially for IL-1 blocking agents with long half-lives such as canakinumab and rilonacept. This may help to ensure an ideal vaccine response in the face of the possibility that AIIRD patients may develop a more pronounced and severe COVID-19 disease course.
Highlights
With its newly emerging variants, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a challenging medical emergency
We aimed to summarize the current literature on all forms of vaccinations under IL-1 blockade to extrapolate relevant data for the use and timing of COVID-19 vaccinations for patients receiving anti-IL-1 therapy
COVID-19 patients with autoimmune/autoinflammatory rheumatic diseases (AIIRD) may be at higher risk of hospitalization, ICU admission, acute renal failure, and venous thromboembolism when compared to COVID-19 patients without systemic AIIRD [36]
Summary
With its newly emerging variants, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a challenging medical emergency. As of the writing of this review, there were over than 226,8 million reported Coronavirus disease 2019 (COVID-19) cases and 4,6 million deaths, since China reported the first cases to the World Health Organization (WHO) in December 2019 [1]. The main cause of death in these patients is acute respiratory distress syndrome which is lethal in nearly 40% of hospitalized patients [2]. Vaccination is the sole effective approach in ending the spread of the pandemic and preventing losses due to COVID-19 without a cure at hand. Pfizer/BioNTech (mRNA), Moderna (mRNA), AstraZeneca (adenovirus vector), Janssen (adenovirus vector), Sinopharm’s Covilo (inactivated SARS-CoV-2 virus), and Sinovac’s CoronaVac (inactivated SARS-CoV-2 virus) are approved by the WHO for global use [3,4,5,6,7,8]. Sputnik V and Covaxin have been authorized for regional use in Russia and India, respectively [9, 10]
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