D2.249 - The impact of the coronavirus infection and vaccination against SARS-CoV-2 in the course of chronic urticaria

According to the definition, urticaria refers to a group of diseases characterized by the development of wheals, angioedema, or both. Triggers of chronic urticaria are most often stress, hormonal drugs, consumption of products with food colorings, preservatives, gastrointestinal diseases, autoimmune pathology, as well as infections, including COVID-19. Due to the fact that the coronavirus epidemic occurred relatively recently, the effect of this virus, as well as vaccination against SARS-CoV-2, on the course of chronic urticaria has not been sufficiently studied. Aim. Evaluation of the impact of SARS-CoV-2 and COVID-19 vaccination on the course of chronic urticaria.

The impact of SARS-CoV-2 and COVID-19 vaccination on the course of chronic urticaria (CU) was assessed in 100 patients from 2021 to 2023 with using the developed questionnaire and the UCT questionnaire. The questionnaire contained 21 questions that assessed the form and duration of CU, the severity of the previous coronavirus infection, the presence of exacerbation or debut of CU against the background of COVID-19, as well as after vaccination against SARS-CoV-2. Patients aged 39±15 years participated in the survey.

The duration of chronic urticaria in most respondents (58%) was more than 2 years, and only 7% less than a year. According to the UCT results, urticaria control before the SARS-CoV-2 epidemic was observed in 67% of patients. COVID-19 was suffered by 64 people, of which 31.5% had a moderate severity of the disease.31.25% of them had a complication in the form of viral pneumonia, but only 6.25% of patients with CU had pneumonia that corresponded to CT2 stage. However, exacerbation of urticaria during of SARS-CoV-2 was observed in 35.9% of patients, and the onset of the disease in 3.1%. It should be noted, that exacerbation of urticaria persisted in all patients for 3 months, and in half for 6 months after the infection.In patients with chronic induced urticaria, SARS-CoV-2 did not affect the course of the disease. Among 7 patients with a combination of spontaneous and induced forms of CU against the background of COVID-19, three people noted an exacerbation of urticaria, and in two of them it persisted for 6 months. Vaccination against COVID-19 was carried out in 67 patients: 63 with the Gam-COVID-Vac vaccine, 4 with CoviVac. Immunoprophylaxis was not recommended for 15 patients due to uncontrolled urticaria. 23,8% patients vaccinated with Gam-COVID-Vac experienced fever and headache on the first day. 8% of patients experienced exacerbation of urticaria.

Patients with chronic urticaria usually have a mild form of COVID-19. However, SARS-CoV-2 causes exacerbation or onset of urticaria in 35.9% of cases. Vaccination with Gam-COVID-Vac is well tolerated by patients with chronic urticaria, and only 8% of cases experience exacerbation of the disease.