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Shafie'ei M, Jamali M, Akbari Z, Sarvipour N, Ahmadzade M, Ahramiyanpour N. Cutaneous adverse reactions following COVID-19 vaccinations: A systematic review and meta-analysis. J Cosmet Dermatol 2022; 21:3636-3650. [PMID: 35861631 PMCID: PMC9350270 DOI: 10.1111/jocd.15261] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND COVID-19 vaccines are currently the most effective interventions in controlling and preventing severe disease progression. Dermatologic reactions to COVID-19 vaccinations may be rare among clinical trial participants. However, since global mass vaccination became a reality, these adverse effects may become more widespread, and different skin reactions would arise. OBJECTIVE To systematically review the cutaneous adverse reactions in cases subject to vaccines for COVID-19. METHODS We searched the PubMed, SCOPUS, Web of Science, and Embase databases, identifying the relevant records and including the eligible observational ones. After assessing the methodological quality of the included studies, we qualitatively and quantitatively synthesized the data regarding the cutaneous side effects experienced by those in the studies' population. RESULTS Overall, 36 studies were included in our systematic review, with the majority being cross-sectional. We found that pain, erythema, and swelling were the most common local side effects, while different types of rashes, urticaria, and angioedema were the most non-local. Few cases also reported experiencing flare-ups of their underlying diseases or developing newly-onset diseases of various etiologies. Our meta-analyses also found that while viral vector-based vaccines are, though insignificantly, safer in injection site complaints, individuals who received mRNA vaccines developed significantly fewer non-local cutaneous adverse events. DISCUSSION Cutaneous reactions to the COVID-19 vaccines are similar to common cutaneous drug eruptions and COVID-19 cutaneous manifestations. However, we believe that further high-quality research is needed to assess better how and why cutaneous reactions occur in different vaccines.
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Affiliation(s)
| | - Marzieh Jamali
- Gene Therapy Research CenterDigestive Diseases Research Institute, Tehran University of Medical SciencesTehranIran
| | - Zahra Akbari
- Faculty of MedicineKerman University of Medical SciencesKermanIran
| | | | - Mohadese Ahmadzade
- Departments of Plastic SurgeryShahid Beheshti University of Medical SciencesTehranIran
| | - Najmeh Ahramiyanpour
- Department of Dermatology, Afzalipour Hospital, Afzalipour Faculty of MedicineKerman University of Medical SciencesKermanIran
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Yuan L, Fan L, Mao Q, Luan X, Wang Z, Zeng N, Cheng Y, Li Y, Xia Q, Lu Z, Lu Q, Min W, Luo D. Clinical Observation and Analysis of Skin Reactions Caused by
COVID
‐19 Vaccination. Dermatol Ther 2022; 35:e15746. [DOI: 10.1111/dth.15746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/09/2022] [Accepted: 07/20/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Li Yuan
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
- Dermatology Department The Fifth People's Hospital of Hainan Province Haikou China
| | - Lipan Fan
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Qiuyu Mao
- Department of Dermatology First Affiliated Hospital of Soochow University Suzhou China
| | - Xingbao Luan
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Zhaopeng Wang
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Ni Zeng
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Yuxin Cheng
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Yueyue Li
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Qingyue Xia
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Zhiyu Lu
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Qian Lu
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Wei Min
- Department of Dermatology First Affiliated Hospital of Soochow University Suzhou China
| | - Dan Luo
- Department of Dermatology The First Affiliated Hospital of Nanjing Medical University Nanjing China
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Chen L, Cai X, Zhao T, Han B, Xie M, Cui J, Zhang J, Wang C, Liu B, Lu Q, Cui F. Safety of Global SARS-CoV-2 Vaccines, a Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10040596. [PMID: 35455344 PMCID: PMC9030038 DOI: 10.3390/vaccines10040596] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 12/19/2022] Open
Abstract
(1) Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines were developed in only a short amount of time and were widely distributed. We conducted this meta-analysis to understand the safety of SARS-CoV-2 vaccines. (2) Methods: We searched the corresponding literature published from 1 January 2020 to 20 October 2021. Information of adverse events (AEs) of each selected work was collected. The quality and bias of studies was evaluated, and meta-analysis was carried out by using Stata 17.0. (3) Results: Totally, 11,451 articles were retrieved, and 53 of them were included for analysis. The incidence rate of AEs was 20.05–94.48%. The incidence rate of vascular events increased after viral vector vaccination, while the incidence rate of vascular events decreased after mRNA vaccination. Viral vector vaccine had a higher AE rate compared to mRNA vaccines and inactivated vaccines. In most circumstances, the incidence of AEs was higher in older people, female and after the second dose. The sensitivity of meta-analysis was acceptable; however, the literature was subject to a certain publication bias. (4) Conclusions: The safety of SARS-CoV-2 vaccines was acceptable. The incidence of allergic symptoms and cardiovascular and cerebrovascular symptoms was low. Viral vector vaccine had a higher risk of leading to thrombosis events. The understanding of SARS-CoV-2 vaccine AEs should be enhanced, so as to promote the vaccination.
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Affiliation(s)
- Linyi Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Xianming Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Bingfeng Han
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Mingzhu Xie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; (L.C.); (X.C.); (T.Z.); (B.H.); (M.X.)
| | - Jiahao Cui
- Faculty of Medicine, Imperial College London, London SW7 2AZ, UK;
| | - Jiayu Zhang
- Bioinformatics Program, School of Science, Xi’an Jiaotong-Liverpool University, Suzhou 215123, China;
| | - Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Qingbin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China; (C.W.); (B.L.); (Q.L.)
- Correspondence: ; Tel./Fax: +86-10-8280-1518
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Urticarial vasculitis: Clinical and laboratory findings with a particular emphasis on differential diagnosis. J Allergy Clin Immunol 2022; 149:1137-1149. [PMID: 35396080 DOI: 10.1016/j.jaci.2022.02.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 02/02/2022] [Accepted: 02/15/2022] [Indexed: 12/22/2022]
Abstract
Urticarial vasculitis (UV) is a rare cutaneous vasculitis of small vessels characterized by recurrent episodes of wheal-like lesions that tend to last more than 24 hours, healing with a residual ecchymotic postinflammatory hyperpigmentation. The histopathologic pattern of UV is that of leukocytoclastic vasculitis, consisting of fibrinoid necrosis of dermal vessels' walls and neutrophil-rich perivascular inflammatory infiltrates. Although its etiopahogenesis remains still undefined, UV is now regarded as an immune complex-driven disease with activation of the complement cascade, leading to exaggerated production of anaphylatoxins that are responsible for neutrophil recruitment and activation. This condition can be categorized into 2 main entities according to serum complement levels: normocomplementemic UV and hypocomplementemic UV, the latter being associated with circulating anti-C1q autoantibodies and possible extracutaneous manifestations. Systemic multiorgan involvement may be seen particularly in syndromic hypocomplementemic UV, also known as McDuffie syndrome. This review summarizes the clinicopathological and laboratory features as well as the underlying pathophysiological mechanisms of UV. A focus on its main differential diagnoses is provided, that is, chronic spontaneous urticaria, bullous pemphigoid, IgA (Henoch-Schönlein purpura) and IgM/IgG immune complex vasculitis, lupus erythematous tumidus, Wells syndrome, erythema multiforme, cutaneous mastocytosis, cryopyrin-associated periodic syndromes, and coronavirus disease 2019-associated and anti-severe acute respiratory syndrome coronavirus 2-vaccine-associated urticarial eruptions.
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Borroni E, Consonni D, Cugno M, Lombardi A, Mangioni D, Bono P, Oggioni M, Uceda Renteria S, Bordini L, Nava CD, Letzgus M, Gentiloni Silverj F, Castaldi S, Rognoni M, Cavallieri D'Oro L, Carugno M, Riboldi L, Ceriotti F, Bandera A, Gori A, Pesatori AC. Side effects among healthcare workers from a large Milan university hospital after second dose of BNT162b2 mRNA COVID-19 vaccine. LA MEDICINA DEL LAVORO 2021; 112:477-485. [PMID: 34939617 PMCID: PMC8759050 DOI: 10.23749/mdl.v112i6.12507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND In Italy, healthcare workers (HCWs) were among the first to receive COVID-19 vaccination. Aim of the present study is to evaluate frequency and severity of adverse events (AEs) following the second dose of BNT162b2 vaccine among HCWs of a large university hospital in Milan, Italy. METHODS One month after having received the second dose of vaccine, HCWs filled-in a form about type, severity, and duration of post-vaccination local and systemic symptoms. We calculated the overall frequency of AEs and used multivariable Poisson regression models (adjusted for sex, age, BMI, smoking, allergy history, previous SARS-CoV-2 infection, anti-hypertensive therapy, and occupation) to calculate risk ratios (RR) and 95% confidence intervals (CI) of AEs according to selected variables. RESULTS We included 3659 HCWs. Overall, 2801 (76.6%) experienced at least one local event, with pain at injection site being the most frequent (2788, 76.2%). Systemic events were reported by 2080 (56.8%) HCWs, with fatigue (52.3%), muscle pain (42.2%), headache (37.7%), joint pain (31.9%), and fever (26.2%) being the most frequent. Risks of systemic events were associated with female gender (RR=1.14, CI: 1.06-1.23), age (strong decrease with increasing age, p-trend<0.001), allergy history (RR=1.13, CI: 1.05-1.20), and current smoking (RR=0.90, CI: 0.84-0.97). HCWs with previous SARS-CoV-2 infection (even if symptomatic) were not at increased risk. CONCLUSIONS Both local and systemic acute effects after second dose of BNT162b2 vaccine were frequently reported. However, symptoms were mostly light/mild and of short duration. Thus, our findings support the safety of COVID-19 vaccination in adults in relatively good health.
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Affiliation(s)
- Elisa Borroni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Massimo Cugno
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Andrea Lombardi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Davide Mangioni
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Patrizia Bono
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Massimo Oggioni
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara Uceda Renteria
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Lorenzo Bordini
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carlo Domenico Nava
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Matteo Letzgus
- Medical Direction, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Silvana Castaldi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy.
| | | | | | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Ferruccio Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Alessandra Bandera
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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