Dermatomyositis in Association With SARS‐CoV‐2 Infection or COVID‐19 Vaccine

• Published in: Arthritis care & research (2010) 2024-01, Vol.76 (1), p.98-104
• Main Authors: Diaz‐Menindez, Maximiliano, Sullivan, Megan M., Wang, Benjamin, Majithia, Vikas, Abril, Andy, Butendieck, Ronald R., Ball, Colleen T., Berianu, Florentina
• Format: Article
• Language: English
• Subjects: COVID-19; COVID-19 - prevention & control; COVID-19 vaccines; COVID-19 Vaccines - adverse effects; Dermatomyositis; Dermatomyositis - diagnosis; Dermatomyositis - epidemiology; Humans; Immunization; Infections; Myositis; Recurrence; Rheumatology; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Vaccination; Vaccines
• ISSN: 2151-464X; 2151-4658; 2151-4658
• DOI: 10.1002/acr.25236

Objective New‐onset and relapsed dermatomyositis (DM) has been reported following SARS‐CoV‐2 infection or COVID‐19 vaccination. This study aims to show the characteristics of a DM cohort after COVID‐19 infection and vaccination. Methods A retrospective review was performed on patients treated for DM between March 1, 2020, and October 31, 2022. Charts were evaluated for the presence of new‐onset DM or relapse of preexisting DM following either SARS‐CoV‐2 infection or COVID‐19 vaccination. Data on symptom onset, timing of vaccination, type of vaccination, and disease characteristics were collected. Results Ninety‐eight patients treated for DM at our institution in the Division of Rheumatology were included. In total, 12 of 98 patients (12.2%) experienced DM symptoms (either incident or relapse) following either infection or vaccination. Of the 12 patients who developed incident disease or relapse, 7 (58.3%) developed postinfection symptoms, and 8 (66.7%) developed symptoms after vaccination (3 patients had symptoms following both infection and vaccination). The mean onset of symptoms following COVID‐19 infection was 3.2 days (median 0.5 days), and mean onset following COVID‐19 vaccination was 5.75 days (median 3.5 days). Nine of 12 patients (75%) had a positive myositis‐specific antibody, and the remaining 3 (25%) had myositis‐associated antibodies. There was no predominant vaccine associated with the development of postvaccination DM symptoms. Conclusion This retrospective review revealed a strong temporal relationship between DM symptoms and COVID‐19 infection or vaccination in 12.2% of all patients with DM evaluated in our clinic during the pandemic. Additional studies are required to understand the possible pathophysiology behind this association.