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, Leonardo Santos Ravichandran, Naveen Shinjo, Samuel Katsuyuki Day, Jessica Sen, Parikshit Junior, Jucier Gonçalves Lilleker, James B Joshi, Mrudula Agarwal, Vishwesh Kardes, Sinan
Hoff, Leonardo Santos
Ravichandran, Naveen
Shinjo, Samuel Katsuyuki
Day, Jessica
Sen, Parikshit
Junior, Jucier Gonçalves
Lilleker, James B
Joshi, Mrudula
Agarwal, Vishwesh
Kardes, Sinan
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Affiliation
Universidade Potiguar; Sanjay Gandhi Postgraduate Institute of Medical Sciences; Universidade de Sao Paulo; Sandwell and West Birmingham NHS Trust
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Publication date
2022-10-22
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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.
Citation
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; 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. 2023 Jan;43(1):47-58. doi: 10.1007/s00296-022-05229-7.
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Article