Predictors of Hospitalization in Breakthrough COVID-19 among Fully Vaccinated Individuals with Immune-Mediated Rheumatic Diseases: Data from SAFER-Study.

Publication date: Sep 09, 2024

Breakthrough COVID-19 (occurring in fully vaccinated people) has been described. Data on its characteristics among immune-mediated rheumatic disease (IMRD) patients are scarce. This study describes breakthrough COVID-19 occurring in IMRD patients participating in the SAFER-study, a Brazilian multicentric cohort evaluating the safety, effectiveness, and immunogenicity of SARS-CoV-2 vaccines in patients with autoimmune diseases. A descriptive analysis of the population and a binary logistic regression model were performed to evaluate the predictors of COVID-19-related hospitalization. A p-value < 0. 05 was significant. The included 160 patients were predominantly females (83. 1%), with a mean (SD) age of 40. 23 (13. 19) years. The patients received two (19%), three (70%), or four (11%) vaccine doses. The initial two-dose series was mainly with ChAdOx1 (Oxford/AstraZeneca) (58%) or BBIBP-CorV (Sinopharm-Beijing) (34%). The first booster (n = 150) was with BNT162b2 (BioNtech/Fosun Pharma/Pfizer) (63%) or ChAdOx1 (29%). The second booster (n = 112) was with BNT162b2 (40%) or ChAdOx1 (26%). The COVID-19 hospitalization rate was 17. 5%. IMRD moderate/high activity (OR: 5. 84; CI: 1. 9-18. 5; p = 0. 002) and treatment with corticosteroids (OR: 2. 94; CI: 1. 02-8. 49; p = 0. 0043) were associated with higher odds of hospitalization, while increasing the number of vaccine doses was protective (OR: 0. 37; CI: 0. 15-0. 9; p = 0. 032). These findings, along with previous reassuring results about the safety of the COVID-19 vaccines, argue in favor of booster vaccination in IMRD patients.

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Concepts	Keywords
Beijing	breakthrough COVID-19 infections
Bnt162b2	COVID-19
Booster	COVID-19 vaccines
Rheumatic	health disparities
Vaccinated	rheumatic diseases

Semantics

Type	Source	Name
disease	MESH	COVID-19
disease	MESH	Rheumatic Diseases
disease	MESH	autoimmune diseases
drug	DRUGBANK	Coenzyme M
drug	DRUGBANK	L-Valine
drug	DRUGBANK	Ribostamycin
disease	MESH	infections
disease	IDO	host
disease	MESH	sequelae
disease	MESH	fibrosis
disease	MESH	chronic kidney disease
disease	MESH	obesity
disease	IDO	cell
drug	DRUGBANK	Methotrexate
disease	MESH	breakthrough infections
disease	MESH	rheumatoid arthritis
pathway	KEGG	Rheumatoid arthritis
disease	MESH	juvenile idiopathic arthritis
disease	MESH	spondylarthritis
disease	MESH	joint diseases
disease	MESH	systemic lupus erythematosus
pathway	KEGG	Systemic lupus erythematosus
disease	MESH	inflammatory myopathies
disease	MESH	systemic vasculitis
disease	MESH	systemic sclerosis
disease	MESH	mixed connective tissue disease
disease	MESH	connective tissue diseases
disease	MESH	psoriasis
drug	DRUGBANK	Methionine
disease	IDO	infection
disease	IDO	blood
drug	DRUGBANK	Oxygen
disease	MESH	death
disease	MESH	chronic infections
disease	MESH	HIV infection
pathway	REACTOME	HIV Infection
disease	MESH	hepatitis
disease	MESH	neoplasms
disease	MESH	cardiomyopathy
disease	MESH	diabetes mellitus
disease	MESH	pulmonary disease
disease	MESH	hypertension
disease	MESH	vasculitis
drug	DRUGBANK	Leflunomide
drug	DRUGBANK	Sulfasalazine
drug	DRUGBANK	Azathioprine
drug	DRUGBANK	Cyclophosphamide
drug	DRUGBANK	Ciclosporin
drug	DRUGBANK	Mycophenolate mofetil
drug	DRUGBANK	Mycophenolic acid
drug	DRUGBANK	Tacrolimus
drug	DRUGBANK	Rituximab
drug	DRUGBANK	Abatacept
drug	DRUGBANK	Belimumab
disease	MESH	asymptomatic infection
disease	MESH	dyspnea
disease	MESH	sore throat
disease	MESH	dysgeusia
disease	MESH	hyposmia
disease	IDO	algorithm
disease	MESH	Comorbidity
drug	DRUGBANK	Prednisone
disease	MESH	Arthralgias
disease	MESH	syndrome
disease	MESH	ankylosing spondylitis
disease	MESH	psoriatic arthritis
disease	MESH	arthritis
disease	MESH	alcoholism
pathway	KEGG	Alcoholism
drug	DRUGBANK	Tofacitinib
drug	DRUGBANK	Baricitinib
disease	MESH	bacterial pneumonia
drug	DRUGBANK	Hyaluronic acid
disease	MESH	IgA vasculitis
drug	DRUGBANK	Monomethyl fumarate
disease	MESH	respiratory failure
disease	MESH	severe acute respiratory syndrome
disease	MESH	acute kidney injury
disease	MESH	privacy
drug	DRUGBANK	Serine
drug	DRUGBANK	Aminosalicylic Acid
drug	DRUGBANK	Efavirenz
disease	MESH	breakthrough COVID-19 infections
disease	MESH	health disparities

Original Article

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