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Steroid impact on the efficacy and safety of SARS-CoV-2 vaccine: a systematic review

  • Pujo Prawiro Negoro ,
  • Gatot Soegiarto ,
  • Laksmi Wulandari ,

Abstract

Background: The COVID-19 vaccine has become the utmost protection against the pandemic, with billions of doses has been used across the globe. Immunosuppression has been one of the leading issues in the vaccination program, one of which should not be handled lightly is the use of the steroid. Thus, this systematic review is aimed to explore the Impact of steroid use on the efficacy and safety of the COVID-19 vaccine.

Methods: The systematic review is conducted based on the PRISMA guideline by conducting a literature search and screening process through several databases (PubMed, ScienceDirect, Scopus, and EBSCOHost) based on the predetermined PICO criteria. Original articles (Controlled trial or cohort) on the use of steroids in healthy or non-immunocompromised or autoimmune patients were included. The included articles were then assessed for risk of bias using the ROBINS-I tool.

Results: 6,857 articles were screened, with two articles included for the final analysis. The results show a non-significant Impact of steroid use on the vaccine efficacy based on seropositivity and antibody count. However, steroid use is related to milder adverse effects and symptoms.

Conclusion: Steroid is not associated with lower response to the COVID-19 vaccine. Further research on the dose-dependent response to steroid use should be conducted.

References

  1. SEARO. Boost COVID-19 vaccination coverage: WHO. World Health Organization. 2022.
  2. Fajar JK, Sallam M, Soegiarto G, Sugiri YJ, Anshory M, Wulandari L, et al. Global Prevalence and Potential Influencing Factors of COVID-19 Vaccination Hesitancy: A Meta-Analysis. Vaccines 2022;10(8):1356.
  3. Lusida MAP, Salamah S, Jonatan M, Syamlan AT, Bandem IKMP, Rahmania AA, et al. The Impact of Facilitated Quarantine on Mental Health Status of Non-Severe COVID-19 Patients. Disaster Med Public Health Prep. 2022;16(5):1751-1752.
  4. Widjaja SS, Jayalie VF, Rusdiana R. Strengthening Palliative and Home Care Service During COVID-19 Pandemic in Developing Country: A Single Institution Report. Open Access Maced J Med Sci. 2022;10(E):1012–1015.
  5. Zeng B, Gao L, Zhou Q, Yu K, Sun F. Effectiveness of COVID-19 vaccines against SARS-CoV-2 variants of concern: a systematic review and meta-analysis. BMC Med. 2022;20(1):1–15.
  6. Soegiarto G, Wulandari L, Purnomosari D, Dhia Fahmita K, Ikhwan Gautama H, Tri Hadmoko S, et al. Hypertension is associated with antibody response and breakthrough infection in health care workers following vaccination with inactivated SARS-CoV-2. Vaccine. 2022;40(30):4046-4056.
  7. Streetman DD. Impact of immunosuppressants on COVID-19 vaccine response. 2021. [Cited 13th October 2022] [Available from: https://www.pharmatimes.com/web_exclusives/Impact_of_immunosuppressants_on_COVID-19_vaccine_response_1372703].
  8. Shen C, Risk M, Schiopu E, Hayek SS, Xie T, Holevinski L, et al. Efficacy of COVID-19 vaccines in patients taking immunosuppressants. Ann Rheum Dis 2022;81(6):875–880.
  9. Chow RM, Rajput K, Howie BA, Varhabhatla N. The COVID-19 vaccine and interventional procedures: Exploring the relationship between steroid administration and subsequent vaccine efficacy. Pain Pract. 2021;21(8):966–973.
  10. Shokouhi S, Hakamifard A. COVID-19 vaccine and corticosteroids: A challenging issue. European Journal of Inflammation 2021;19:1–2.
  11. Rubin LG, Levin MJ, Ljungman P, Davies EG, Avery R, Tomblyn M, et al. IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis. 2014;58(3):309–318.
  12. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;88:372.
  13. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928.
  14. Nakajima T, Nagano T, Miyata Y, Murakami S, Mitsuyuki S, Funakoshi Y, et al. Inhaled corticosteroids do not affect the antibody titer against the SARS-CoV-2 spike protein in BNT162b2 mRNA vaccinated patients. Allergy, Asthma Clin Immunol. 2022;18(1):1–6.
  15. Yang J, Ko JH, Baek JY, Hong J, Ha S, Lee B, et al. Effects of Short-Term Corticosteroid Use on Reactogenicity and Immunogenicity of the First Dose of ChAdOx1 nCoV-19 Vaccine. Front Immunol. 2021;12:744206.
  16. Mudatsir M, Fajar JK, Wulandari L, Soegiarto G, Ilmawan M, Purnamasari Y, et al. Predictors of COVID-19 severity: a systematic review and meta-analysis. F1000Research. 2021;9(9):1–26.
  17. Inoue S, Shibata Y, Takabatake N, Igarashi A, Abe S, Kubota I. Influence of corticosteroid therapy on the serum antibody response to influenza vaccine in elderly patients with chronic pulmonary diseases. EXCLI J. 2013;12:760-765.
  18. De Roux A, Marx A, Burkhardt O, Schweiger B, Borkowski A, Banzhoff A, et al. Impact of corticosteroids on the immune response to a MF59-adjuvanted influenza vaccine in elderly COPD-patients. Vaccine. 2006;24(10):1537–1542.
  19. Naito M, Itoh K, Komatsu N, Yamashita Y, Shirakusa T, Yamada A, et al. dexamethasone did not suppress immune boosting by personalized peptide vaccination for advanced prostate cancer patients. Prostate. 2008;68(16):1753–1762.
  20. Steentoft J, Konradsen HB, Hilskov J, Gislason G, Andersen JR. Response to pneumococcal vaccine in chronic obstructive lung disease--the effect of ongoing, systemic steroid treatment. Vaccine. 2006;24 (9):1408–1412.
  21. Herawati S, Kandarini Y, Mulyantari NK, Prabawa PY. Correlation of Neutrophil to Lymphocyte Ratio with Interleukin-10 in Diagnosis and Monitoring of Coronavirus Disease-19 Patients. Open Access Maced J Med Sci. 2022;10(B):63-66.
  22. Pranata S, Vranada A, Armiyati Y, Samiasih A, Aisah S, Kurnia A, et al. Inflammatory markers for predicting severity, mortality, and need for intensive care treatments of a patient infected with covid-19: a scoping review. Bali Medical Journal. 2023;12(1):324–330.
  23. Sytsma TT, Greenlund LK, Greenlund LS. Joint Corticosteroid Injection Associated With Increased Influenza Risk. Mayo Clin proceedings Innov Qual outcomes. 2018;2(2):194–198.
  24. Widjaja SS, Rusdiana R, Amelia R. Curcumin: Boosting the immunity of COVID-19-vaccinated populations. J Adv Pharm Technol Res. 2022;13(3):187–190.
  25. Ansori I, Riefani S, Nurrasyidah I. The Correlation of Rapid Antibody Results with SARS-CoV-2 PCR in COVID-19 Patients in Ulin General Hospital Banjarmasin. Jurnal Respirasi Unair. 2021;7(3):100–105.
  26. Hasanudin H, Sukartini T, Makhfudli M. The Effectiveness of Pulmonary Rehabilitation on Pulmonary Function among Adult Patient of COVID-19 Survivor. Jurnal Respirasi Unair. 2022;8(1):15-25.

How to Cite

Pujo Prawiro Negoro, Gatot Soegiarto, & Laksmi Wulandari. (2023). Steroid impact on the efficacy and safety of SARS-CoV-2 vaccine: a systematic review. Bali Medical Journal, 12(1), 826–830. https://doi.org/10.15562/bmj.v12i1.3947

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Pujo Prawiro Negoro
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Gatot Soegiarto
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Laksmi Wulandari
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