What the SARS-CoV-2 Pandemic Has Taught Us About Immunosuppression, Vaccinations, and Immune Dysregulation: The Rheumatology Experience

IF 5.4 2区医学 Q1 ALLERGY Current Allergy and Asthma Reports Pub Date : 2024-04-03 DOI:10.1007/s11882-024-01139-9

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Abstract

Purpose of Review

This review reflects on the impact of the COVID-19 pandemic on the field of rheumatology, emphasizing resulting insights related to the risks of viral infections in immunosuppressed patients, vaccine immunogenicity in immunocompromised patients, and immune dysregulation in the setting of viral infection.

Recent Findings

During the pandemic, global patient registries provided real-time insights into the risk factors associated with severe COVID-19 outcomes in rheumatology patients. Updated evidence-based recommendations from the American College of Rheumatology (ACR) guided rheumatology practice during a time of considerable uncertainty. Studies on COVID-19 vaccines in immunocompromised populations enhanced our understanding of specific immunosuppressive therapies on vaccine efficacy. The immune dysregulation seen in severe COVID-19 underscored a role for immunomodulation in this and other severe infections. Furthermore, novel post-infectious conditions, namely multisystem inflammatory syndrome in children (MIS-C) and Long COVID, reshaped our understanding of post-viral syndromes and revealed novel pathological mechanisms.

Summary

Lessons from the COVID-19 pandemic demonstrate the power of collaborative research. The scientific revelations from this dreadful time will, nonetheless, benefit the practice of rheumatology for years to come.

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SARS-CoV-2 大流行给我们的免疫抑制、疫苗接种和免疫失调启示：风湿病学的经验

摘要综述目的本综述反映了 COVID-19 大流行对风湿病学领域的影响，强调了与免疫抑制患者的病毒感染风险、免疫功能低下患者的疫苗免疫原性以及病毒感染情况下的免疫失调有关的最新研究成果。最新发现在大流行期间，全球患者登记提供了与风湿病患者严重 COVID-19 后果相关的风险因素的实时见解。美国风湿病学会 (ACR) 提出的最新循证建议为风湿病学的临床实践提供了指导。对免疫功能低下人群接种 COVID-19 疫苗的研究加深了我们对特定免疫抑制疗法对疫苗疗效的了解。在严重的 COVID-19 中出现的免疫失调强调了免疫调节在这种感染和其他严重感染中的作用。此外，新的感染后病症，即儿童多系统炎症综合征（MIS-C）和长COVID，重塑了我们对病毒后综合征的认识，并揭示了新的病理机制。总结 COVID-19 大流行的经验教训证明了合作研究的力量。尽管如此，这一可怕时期的科学启示仍将使风湿病学的实践受益多年。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Allergy and Asthma Reports 医学-过敏

CiteScore

11.20

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.

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