Table 4.
Clinical characteristics of patients who presented flare post-immunization against SARS-CoV-2
| Sex/age (years) | Illness time (SLE) | SLE-associated systemic involvement | Standard treatment | Flare in 6 months prior to immunization | Flare type after the 1st immunization dose | Flare type after the 2nd immunization dose | |
|---|---|---|---|---|---|---|---|
| 1 |
F 21 |
2 years | Renal, cardiovascular (valvulitis, pericarditis), articular | Prednisone Hydroxychloroquine Azathioprine | Yes |
Cardiac flare-up (Myopericarditis) Decrease in LVEF 30% * Pericardial effusion 600 cc Articular flare-up In-hospital management (corticosteroid therapy 1 mg/kg, mycophenolate) |
Did not vaccinate |
| 2 |
F 37 |
5 years | Renal, hematologic (leukopenia), articular | No treatment | No |
Hematological flare-up (leukopenia 2000) †. Outpatient management. |
Musculoskeletal (arthritis
) flare-up. Outpatient management |
| 3 |
F 37 |
6 months | Articular, alopecia | No treatment | No | Musculoskeletal (arthritis) flare-up. Outpatient management | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 4 |
M 80 |
5 years | Hematologic (leukopenia), pulmonary (ILD‡), articular. | Prednisone Mycophenolate | No | Pulmonary flare-up (lupus pneumonitis), in-hospital management (methylprednisolone pulses, cyclophosphamide) | Did not vaccinate |
| 5 |
F 44 |
11 years | Dermal (malar erythema), mucocutaneous (oral ulcers), articular | Prednisone Methotrexate Leflunomide | Yes | Musculoskeletal (arthritis) flare-up. Outpatient management | Dermal flare-up (erythema malar), Musculoskeletal (arthritis) flare-up. Outpatient management |
| 6 |
F 27 |
10 years | Dermal (malar erythema), articular, neurological (convulsions) | No treatment | Yes | Musculoskeletal (arthritis) flare-up. Outpatient management | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 7 |
F 37 |
6 years | Renal, articular | Hydroxychloroquine Mycophenolate | No | Musculoskeletal (arthritis) flare-up. Outpatient management | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 8 |
M 42 |
19 years | Hematologic (plateletopenia), pulmonary (pleural effusion), dermal (malar erythema), articular | Prednisone Hydroxychloroquine Azathioprine Methotrexate | Yes | Musculoskeletal (arthritis) flare-up. Outpatient management | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 9 |
F 43 |
9 years | Dermal (malar erythema), mucocutaneous (oral ulcers), articular, neurological (convulsions) | Prednisone | No | Musculoskeletal (arthritis) flare-up, dermal flare-up (erythema malar), outpatient management | Musculoskeletal (arthritis) flare-up, dermal flare-up (erythema malar), outpatient management |
| 10 |
F 21 |
5 years | Renal, dermal (malar erythema), articular | Prednisone Mycophenolate | No | – | Dermal flare-up (erythema malar, alopecia), outpatient management |
| 11 |
F 34 |
14 years | Renal, mucocutaneous (oral ulcers), articular. | Prednisone Hydroxychloroquine Azathioprine | No | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 12 |
F 42 |
5 years | Articular | Prednisone Methotrexate | No | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 13 |
F 29 |
5 years | Renal, hematologic (plateletopenia), mucocutaneous, articular | Prednisone Hydroxychloroquine Azathioprine | No | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 14 |
F 55 |
3 years | Polyserositis, articular | Prednisone Hydroxychloroquine Azathioprine | Yes | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 15 |
F 38 |
12 years | Renal | Prednisone Hydroxychloroquine Azathioprine | No | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 16 |
F 24 |
4 years | Renal, articular | Prednisone | No | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 17 |
F 46 |
9 years | Dermal, articular | Prednisone Hydroxychloroquine Azathioprine | No | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
| 18 |
F 25 |
3 years | Articular | Prednisone Hydroxychloroquine Azathioprine | Yes | – | Dermal flare-up (erythema malar) Musculoskeletal (arthritis) flare-up. Outpatient management |
| 19 |
F 33 |
4 months | Hematologic (hemolytic anemia, antiphospholipid antibodies) | Prednisone Hydroxychloroquine Azathioprine | Yes | – | Musculoskeletal (arthritis) flare-up. vascular (Raynaud’s) flare-ups. Outpatient management |
| 20 |
F 58 |
12 years | Hematologic (plateletopenia), articular | Prednisone Hydroxychloroquine Azathioprine | Yes | – | Musculoskeletal (arthritis) flare-up. Outpatient management |
*Patient in previous evaluations had LVEF 46%
†In the control prior to immunization, the patient presented 5000 leukocytes
Arthritis (synovitis, tumefaccion, flogosis, limitacion funcional)
‡ILD diffuse interstitial lung disease. LVEF left ventricular ejection fraction