Background: Systemic vasculitis is a heterogeneous group of rare diseases with clinical symptoms characterized by inflammation of blood vessels, frequently affecting different organs and vascular areas of the body. At the end of 2019, the SARS-CoV2 virus began its spread across the planet, consolidating the most recent pandemic we have faced. As the contagion progressed, medical professionals began to see characteristic signs of vasculitis in affected patients. Several studies have shown the presence of complications in COVID-19 related to a cytokine storm and immune hyperactivation, as occurs with other viruses such as hepatitis B virus or Epstein Barr virus.

Objectives: The main objective of the study is to identify and describe cases of vasculitis diagnosed during or after recent Sars-CoV2 infection and after vaccination, in people over 18 years of age with all the information available in the literature from its beginning in 2019 to August 2023.

Methods: A systematic review was carried out in Pubmed, Embase, Ovid, Web Of Science and abstract databases from different scientific societies in which the occurrence of vasculitis after SARS-CoV2 infection or in relation to vaccination against the virus was mentioned.

A total of 1511 articles were included (637 from PubMed, 205 from Ovid, 283 from SCOPUS, 386 from WoS and 8 abstracts from scientific societies). After removing duplicates and screening by title/abstract, 174 articles were selected (95 related to vasculitis after COVID infection and 79 related to vasculitis after vaccination). Subsequently, through a process of reverse review and complete reading, 45 articles (48 cases) of vasculitis after infection and 86 articles (114 cases) of vasculitis as an adverse reaction after vaccination against the virus would finally be included for analysis.

Results: Vasculitis after SARS-CoV2 infection

Vasculitis after COVID vaccination

Conclusion: Our results suggest a possible relationship between SARS-CoV2 vaccination/infection and the development of vasculitis. In both cases, the most frequently reported type of vasculitis was small vessel vasculitis, specifically leukocytoclastic vasculitis. The most frequent clinical manifestations in post-infection vasculitis were skin and upper airway involvement in the presence of fever and general syndrome. In the case of post-vaccination vasculitis, the most frequent symptoms were cutaneous and arthralgias, with up to 20% of cases showing renal involvement. Regarding the number of vaccines received, vasculitis was more frequent among those who received a single dose and those from the Pfizer laboratory. Treatment and its response do not seem to differ with respect to vasculitis not associated with SARS-CoV2 infection or vaccination compared to other cases. Likewise, the safety profile of the drugs administered does not seem to be worse than for the treatment of vasculitis not associated with the SARS-CoV2 virus.

REFERENCES: [1] Rodríguez Y, Rojas M, Beltrán S, Polo F, Camacho-Domínguez L, Morales SD, Gershwin ME, Anaya JM. Autoimmune and autoinflammatory conditions after COVID-19 vaccination. New case reports and updated literature review. J Autoimmun. 2022 Oct;132:102898. DOI: 10.1016/j.jaut.2022.102898. Epub 2022 Aug 24. PMID: 36041291; PMCID: PMC9399140.

[2] Wong K, Farooq Alam Shah MU, Khurshid M, Ullah I, Tahir MJ, Yousaf Z. COVID-19 associated vasculitis: A systematic review of case reports and case series. Ann Med Surg (Lond). 2022 Feb;74:103249. DOI: 10.1016/j.amsu.2022.103249. Epub 2022 Jan 13. PMID: 35039779; PMCID: PMC8754903.

Acknowledgements: NIL.

Disclosure of Interests: None declared.