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

Albert Selva O'Callaghan, Leonardo Santos Hoff, Naveen Ravichandran, Samuel Katsuyuki Shinjo, Jessica Day, Parikshit Sen, Jucier Gonçalves Junior, James B. Lilleker, Mrudula Joshi, Vishwesh Agarwal, Sinan Kardes, Minchul Kim, Marcin Milchert, Ashima Makol, Tamer Gheita, Babur Salim, Tsvetelina Velikova, Abraham Edgar Gracia-Ramos, Ioannis Parodis, Elena NikiphorouAi Lyn Tan, Tulika Chatterjee, Lorenzo Cavagna, Miguel A. Saavedra, Nelly Ziade, Johannes Knitza, Masataka Kuwana, Arvind Nune, Oliver Distler, Döndü Üsküdar Cansu, Lisa Traboco, Suryo Angorro Kusumo Wibowo, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Chris Wincup, John D. Pauling, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta

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9 Citations (Scopus)

Abstract

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). 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. 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). 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. The online version contains supplementary material available at 10.1007/s00296-022-05229-
Original languageEnglish
Pages (from-to)1-12
Number of pages12
JournalRheumatology International
DOIs
Publication statusPublished - 2022

Keywords

  • Autoimmune diseases
  • Breakthrough infection
  • COVID-19
  • Idiopathic inflammatory myopathies
  • SARS-CoV-2 vaccination

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