학술논문
COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey
Document Type
Author
Hoff, Leonardo Santos; Ravichandran, Naveen; Shinjo, Samuel Katsuyuki; Day, Jessica; Sen, Parikshit; Junior, Jucier Gonçalves; Lilleker, James B.; Joshi, Mrudula; Agarwal, Vishwesh; Kardes, Sinan; Kim, Minchul; Milchert, Marcin; Makol, Ashima; Gheita, Tamer; Salim, Babur; Velikova, Tsvetelina; Gracia-Ramos, Abraham Edgar; Parodis, Ioannis, 1981; O'Callaghan, Albert Selva; Nikiphorou, Elena; Tan, Ai Lyn; Chatterjee, Tulika; Cavagna, Lorenzo; Saavedra, Miguel A.; Ziade, Nelly; Knitza, Johannes; Kuwana, Masataka; Nune, Arvind; Distler, Oliver; Cansu, Döndü Üsküdar; Traboco, Lisa; Wibowo, Suryo Angorro Kusumo; Tehozol, Erick Adrian Zamora; Serrano, Jorge Rojas; La Torre, Ignacio García-De; Wincup, Chris; Pauling, John D.; Chinoy, Hector; Agarwal, Vikas; Aggarwal, Rohit; Gupta, Latika
Source
Rheumatology International. 43(1):47-58
Subject
Language
English
ISSN
0172-8172
1437-160X
1437-160X
Abstract
OBJECTIVES: We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs).METHODS: This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis.RESULTS: Among 10,900 respondents [42 (30-55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4-0.8, and OR = 0.3, 95% CI 0.2-0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2-5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3-5.3 in BI]. In a multivariate regression analysis, age 30-60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5-1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1-2.7).CONCLUSIONS: Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.