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

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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