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.
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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, 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, COVAD Study Group
Аннотация
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.