The Association Between COVID-19 Vaccination and Rheumatoid Arthritis Relapse: A Cross-sectional Study

Abstract

Background: Coronavirus disease (COVID-19) was one of the viral pandemics that affected many patients, including those with rheumatoid arthritis (RA). Vaccination in COVID-19 patients has sometimes led to a relapse of RA, but few studies have been conducted in this field. Objectives: In this study, we investigated the association between the vaccination of COVID-19 patients and the relapse of RA. Methods: This is a cross-sectional study. The patients participating in this study are those with RA who have undergone COVID-19 vaccination. Ninety-eight patients (convenience sampling) were analyzed in this study. They were selected from the patients admitted to the Rheumatology Department of Al-Zahra Hospital, Isfahan, between 2020 and 2021. The patients' RA disease was under control and had a disease activity score-28 (DAS-28 < 2.6). All patients were examined by a rheumatologist before participating in the study. Results: In dose I, the Sinopharm vaccine had a higher number of patients with DAS-28 improvement and worsening compared to the other vaccines. There was no change in DAS-28 status in patients who received the Sputnik vaccine (P = 0.55). At dose II, the Sinopharm vs. Barekat vaccine had a higher number of patients with DAS-28 improvement and worsening compared to the other vaccines (P = 0.51). At dose III, only one patient who received the Barekat vaccine had a DAS-28 improvement. In contrast, five patients who received the Sinopharm vaccine had a worsening of DAS-28 compared to the pre-injection period (P = 0.21). Conclusions: No association was found between the type of vaccines in all three doses and DAS-28 in the patients. Copyright © 2025, Salesi et al.