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

Hoff, LS; Ravichandran, N; Shinjo, SK; Day, J; Sen, P; Junior, JG; Lilleker, JB; Joshi, M; Agarwal, V; Kardes, S; Kim, M; Milchert, M; Makol, A; Gheita, T; Salim, B; Velikova, T; Gracia-Ramos, AE; Parodis, I; O&#39;Callaghan, AS; Nikiphorou, E; Tan, AL; Chatterjee, T; Cavagna, L; Saavedra, MA; Ziade, N; Knitza, J; Kuwana, M; Nune, A; Distler, O; Cansu, D&#220;; Traboco, L; Wibowo, SAK; Tehozol, EAZ; Serrano, JR; La Torre, IG; Wincup, C; Pauling, JD; Chinoy, H; Agarwal, V; Aggarwal, R; Gupta, L

Author(s): Hoff, LS; Ravichandran, N; Shinjo, SK; Day, J; Sen, P; Junior, JG; Lilleker, JB; Joshi, M; Agarwal, V; Kardes, S; Kim, M; Milchert, M; Makol, A; Gheita, T; Salim, B; Velikova, T; Gracia-Ramos, AE; Parodis, I; O'Callaghan, AS; Nikiphorou, E; Tan, AL; Chatterjee, T; Cavagna, L; Saavedra, MA; Ziade, N; Knitza, J; Kuwana, M; Nune, A; Distler, O; Cansu, DÜ; Traboco, L; Wibowo, SAK; Tehozol, EAZ; Serrano, JR; La Torre, IG; Wincup, C; Pauling, JD; Chinoy, H; Agarwal, V; Aggarwal, R; Gupta, L;
Details: Publication Year 2023-10-22,Volume 43,Issue #1,Page 47-58
Journal Title: Rheumatology International
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.
Publisher: Springer
Keywords: Autoimmune diseases; Breakthrough infection; Covid-19; Idiopathic inflammatory myopathies; SARS-CoV-2 vaccination
Research Division(s): Inflammation
PubMed ID: 36271958
Publisher's Version: https://doi.org/10.1007/s00296-022-05229-7
Open Access at Publisher's Site: https://doi.org/10.1007/s00296-022-05229-7
Terms of Use/Rights Notice: Refer to copyright notice on published article.
Documents: s00296-022-05229-7.pdf - (0.63MB, application/pdf)

Creation Date: 2023-02-02 02:06:28

Last Modified: 2023-05-03 09:56:17