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© 2022 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.The aim of this study is to evaluate development of side effects, thrombotic or obstetric complications in our antiphospholipid syndrome (APS) patient group, after vaccination against coronavirus disease 2019 (COVID-19). A cohort was formed from patients who have previously been followed up with a diagnosis of APS. The patients of the cohort were evaluated retrospectively to find out if they were vaccinated with CoronaVac and/or BNT162b2 vaccines which are being used in our country. To evaluate the side effects seen after the vaccination, the information was collected by the patients in their outpatient appointments or making a phone call. Thirty-five APS patients who had received at least 1 dose of any of the COVID-19 vaccines were included in the study. Median (min–max) number of vaccine doses per patient was 2 (1–3). Eleven patients had a booster dose after primary vaccination. Twenty patients were ever vaccinated with BNT162b2 and 18 with CoronaVac. Among BNT162b2 recipients, 9 (45.0%) and among CoronaVac recipients 15 (42.9%) reported an adverse event after a vaccine administration. The most common adverse events were myalgia and malaise after any dose of both vaccines. No vaccine-related new thrombotic events or APS flares were observed. Our results were comparable with those reported in the literature. Comprehensive large-scale studies are needed for more accurate results on the evaluation of side effects after COVID-19 vaccination in APS patients.

To determine frequency of adverse events and attacks related to vaccination in recipients of CoronaVac and BNT162b2 in familial Mediterranean fever (FMF) patients, and to search whether history of prior COVID-19 or a booster dose increases occurrence of adverse events/attacks.FMF patients were surveyed for administration of any COVID-19 vaccine and vaccine-related adverse events or FMF attacks. Demographic, clinical, vaccine-related data, history of COVID-19 infection before or after vaccination, adherence to FMF treatment during vaccination were collected.A total of 161 vaccinated FMF patients were included. Ninety-three patients out of 161 had reported suffering from an adverse event/attack after a vaccine dose. There were 54.7% of BNT162b2 recipients who reported any adverse event after any vaccine dose in comparison to 29.9% of CoronaVac recipients (P .001). There were 22.2% of BNT162b2 recipients who reported suffering from a FMF attack within 1 month after vaccination in comparison to 19.4% of CoronaVac recipients (P = .653). When patients with or without adverse event/attack were compared, no significant differences were observed in means of demographics, comorbid diseases, disease duration, total vaccine doses, or treatments adhered to for FMF. Rates of adverse events/attacks were similar between patients with and without prior COVID-19. In booster recipients, adverse events/attacks were most frequent after the booster dose.A considerable number of FMF patients suffered from vaccine-related adverse events/attacks, particularly with BNT162b2. No serious events or mortalities due to vaccination were detected. Demographics, clinical characteristics and prior history of vaccination did not significantly affect these results. We observed an increased rate of adverse events/attacks with booster dose administration.

Background Patients with rheumatological complaints may visit an emergency department (ED) because of an acute attack or complication. Because of the recent increased use of immunosuppressant drugs to treat rheumatic diseases, more patients with these conditions visit the ED with a complaint about an infection. However, there are little data on the ED visits of patients with rheumatological complaints. This study evaluated the ED visits of patients with inflammatory rheumatic diseases. Materials and methods A total of 2715 patients (1753 females, 962 males) who had been diagnosed with an inflammatory rheumatic disease and followed up at the rheumatology clinic of Yildirim Beyazit University, Ankara Ataturk Training and Research Hospital between April 2014 and April 2018 were included in the study. The demographic, clinical, and laboratory characteristics of the patients were obtained from the hospital patient records. The ED visits of these patients were classified into five triage groups (T1: critical, T2: very urgent, T3: urgent, T4: less urgent, T5: not urgent). Results Of the 2715 patients, 577 (21.3%) had visited the ED. The three most numerous groups who visited the ED were patients with rheumatoid arthritis (19.8%), ankylosing spondylitis (19.2%), and familial Mediterranean fever (15.9%). Of these 577 patients, 347 (60.1%) were discharged from the ED, 209 (36.2%) were hospitalized in the wards, and 21 (3.6%) were hospitalized in the intensive care unit (ICU). The 3 main reasons for visiting the ED were fever and malaise (n = 152, 26.3%), musculoskeletal complaints (n = 125, 21.7%), and abdominal pain (n = 89, 15.4%). The most numerous group of patients referred by the ED to the wards had vasculitis (n = 38, 17.9%), while the most numerous group of patients referred to the ICU had scleroderma (n = 7, 33.3%). Of the 21 patients who were referred by the ED to the ICU, 16 (76.1%) had respiratory system complaints. Of the 577 patients, 10 (1.7%) died. Eight of the 10 patients (80%) had a rheumatic disease and died after admission to the ICU. The other 2 patients had been diagnosed with pneumonia and myocardial infarction, respectively. Conclusions Our study found that visits to the ED by patients with inflammatory rheumatic diseases were classified as urgent or less urgent. Patients with rheumatoid arthritis were the most numerous ED visitors. Vasculitis was the most common cause of hospitalization in the wards and scleroderma was the most common cause of hospitalization in the ICU and death. This suggests that ED physicians should be aware of these patients.

Aim To evaluate the sleep quality and the relation of sleep quality with depression, anxiety, fatigue and disease activity in adult patients with familial Mediterranean fever (FMF). Method One hundred and seventy-four FMF patients and 84 age-sex matched healthy individuals were included in this study. The Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF) and the Hospital Anxiety and Depression Index (HADS) were used to assess sleep quality, fatigue, depression and anxiety, respectively. Result FMF patients had significantly higher depression, anxiety, fatigue and PSQI scores than healthy controls. As the severity of the disease increased, scores of total PSQI and its domains increased. Patients with total PSQI score higher than 5 had statistically significantly higher erythrocyte sedimentation rates (ESR), serum C-reactive protein and serum amyloid levels during attacks, more attack numbers in last 3 months and worse fatigue, depression scores. Total PSQI score was positively correlated with inflammatory markers during attacks, attack numbers in the last 3 months and fatigue score. Logistic regression models identified disease duration, ESR during attacks, fatigue, attack numbers in the last 3 months as predictors of poor sleep quality. Conclusion Poor sleep quality is common in adult FMF patients. Anxiety, depression and fatigue are more frequent in FMF patients than healthy individuals. Poor sleep quality is associated with inflammatory marker levels during attacks, fatigue and attack numbers in the last 3 months.