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

Gupta, Latika

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

Authors

Gupta, Latika

Issue Date

2023-01-01

Type

Multicentre Study
Observational Study
Peer-Reviewed Publication

Keywords

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

Journal Title

Rheumatology International

Volume

43

Issue

1

Begin page

1
47

End page

12
58

Full item page

URI

https://rwt.dspace-express.com/handle/20.500.12687/1319

DOI

https://doi.org/10.1007/s00296-022-05229-7

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 infammatory 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 col lected 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 defned 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 hospitaliza tion. 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

Citation

off 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; COVAD Study Group. 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. Rheumatol Int. 2022 Oct 22:1–12. doi: 10.1007/s00296-022-05229-7. Epub ahead of print. PMID: 36271958; PMCID: PMC9589602.