PGY-3, Pediatric Resident Nemours Children's Hospital Orlando, Florida, United States
Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease that produces autoantibodies and immune complexes throughout the body. Lupus flares occur when a patient has an increase in SLE disease activity, demonstrated through serologic measurements and SLE related symptoms. Many parents are concerned that the COVID 19 vaccine will lead to a flare of their child’s lupus. There are scientific studies that analyze the vaccine’s effectiveness in adult patients with Lupus. The team discovered case reports in adult patients of Lupus flares, and possible new onset Lupus following administration of the COVID 19 vaccine. There are few reports that analyze if the COVID 19 vaccine is safe for pediatric patients with SLE. Objective: To analyze if there is a correlation between the COVID 19 vaccine and lupus flares in pediatric patients with SLE. Design/Methods: This is a retrospective cohort study approved by the Nemours Institutional Review Board (IRB). A medical record review was performed of patients with SLE at Nemours Children’s Health- Florida and Nemours Children’s- Health Delaware. We included patients with SLE ages 5-18 by ICD-10 code who received 2 doses of the COVID 19 vaccine. The data analyzed started in June 2021 when the COVID 19 vaccination was approved for pediatric patients between 12-18 years old, and included data after the vaccine was approved for ages 5-11. SLEDAI score values were calculated based on the patient’s visit before their first COVID 19 vaccination and the visit following the second COVID 19 vaccination. SLEDAI score values include seizure, psychosis, organic brain syndrome, visual disturbance, cranial nerve disorder, lupus headache, CVA, vasculitis, arthritis, myositis, urinary casts, hematuria, proteinuria, pyuria, rash, alopecia, mucosal ulcers, pleurisy, pericarditis, low complement, increased DNA binding, thrombocytopenia, and leukopenia. SELENA-SLEDAI Instrument Score was used to calculate the SLEDAI score. Statistical analysis of the data was assessed using a paired t-test. A p value < 0.05 was set to indicate statistical significance.
