Objectives: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. Methods: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI, and hospitalizations among patients with IIMs. Results: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3%). The median age was 44 years [interquartile range (IQR) 21], 77.4% were female, and 182 BIs (12.9%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95% CI = 1.24-2.64, and HR = 3.79, 95% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0% vs AIRDs = 1.8%, nrAIDs = 2.2% and HCs = 0.9%), intensive care unit admission (IIMs = 2.2% vs AIRDs = 0.6%, nrAIDs and HCs = 0%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1% vs AIRDs = 25.8%, nrAIDs = 14.6% and HCs = 12.8%) and had more hospitalization (IIMs = 7.7% vs AIRDs = 4.6%, nrAIDs = 1.1% and HCs = 1.5%). Conclusion: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.
Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: Results from the COVAD study / Hoff, L. S.; Ravichandran, N.; Sen, P.; Day, J.; Joshi, M.; Nune, A.; Nikiphorou, E.; Saha, S.; Tan, A. L.; Shinjo, S. K.; Ziade, N.; Velikova, T.; Milchert, M.; Jagtap, K.; Parodis, I.; Gracia-Ramos, A. E.; Cavagna, L.; Kuwana, M.; Knitza, J.; Chen, Y. M.; Makol, A.; Agarwal, V.; Patel, A.; Pauling, J. D.; Wincup, C.; Barman, B.; Tehozol, E. A. Z.; Serrano, J. R.; Torre, I. G. -D. L.; Colunga-Pedraza, I. J.; Merayo-Chalico, J.; Chibuzo, O. C.; Katchamart, W.; Goo, P. A.; Shumnalieva, R.; El Kibbi, L.; Halabi, H.; Vaidya, B.; Shaharir, S. S.; Hasan, A. T. M. T.; Dey, D.; Gutierrez, C. E. T.; Caballero-Uribe, C. V.; Lilleker, J. B.; Salim, B.; Gheita, T.; Chatterjee, T.; Distler, O.; Saavedra, M. A.; Chinoy, H.; Agarwal, V.; Aggarwal, R.; Gupta, L.; Singh, Y. P.; Ranjan, R.; Jain, A.; Pandya, S. C.; Pilania, R. K.; Sharma, A.; Manesh Manoj, M.; Gupta, V.; Kavadichanda, C. G.; Patro, P. S.; Ajmani, S.; Phatak, S.; Goswami, R. P.; Chowdhury, A. C.; Mathew, A. J.; Shenoy, P.; Asranna, A.; Bommakanti, K. T.; Shukla, A.; Pande, A. R.; Gaur, P. S.; Mamadapur, M.; Ghodke, A.; Chandwar, K.; Kadam, E.; Fazal, Z. Z.; Kardes, S.; Cansu, D. U.; Ylldlrlm, R.; Gasparyan, A. Y.; Giannini, M.; Maurier, F.; Campagne, J.; Meyer, A.; Del Papa, N.; Sambataro, G.; Fabiola, A.; Govoni, M.; Parisi, S.; Bocci, E. B.; Sebastiani, G. D.; Fusaro, E.; Sebastiani, M.; Quartuccio, L.; Franceschini, F.; Sainaghi, P. P.; Orsolini, G.; De Angelis, R.; Danielli, M. G.; Venerito, V.; Grignaschi, S.; Giollo, A.; Andreoli, L.; Lini, D.; Alluno, A.; Iannone, F.; Fornaro, M.; Traboco, L. S.; Wibowo, S. A. K.; Loarce-Martos, J.; Prieto-Gonzalez, S.; Aranega, R.; Yoshida, A.; Nakashima, R.; Sato, S.; Kimura, N.; Kaneko, Y.; Gono, T.; Tomaras, S.; Proft, F. N.; Holzer, M. -T.; Gromova, M. A.; Aharonov, M. O.; Nagy-Vincze, M.; Griger, Z.; Schrieber, K.; Hmamouchi, I.; El Bouchti, P. I.; Baba, Z.; Ima-Edomwonyi, U.; Dedeke, I.; Airenakho, E.; Madu, N. H.; Yerima, A.; Olaosebikan, H.; Becky, A.; Koussougbo, O. D.; Palalane, E.; Langguth, D.; Limaye, V.; Needham, M.; Srivastav, N.; Hudson, M.; Landon-Cardinal, O.; Zuleta, W. G. R.; Arbelaez, A.; Cajas, J.; Silva, J. A. P.; Fonseca, J. E.; Zimba, O.; Bohdana, D.; So, H.; Ugarte-Gil, M. F.; Chinchay, L.; Bernaola, J. P.; Pimentel, V.; Fathi, H. M.; Mohammed, R. H. A.; Harifi, G.; Fuentes-Silva, Y.; Cabriza, K.; Losanto, J.; Colaman, N.; Cachafeiro-Vilar, A.; Bautista, G. G.; Ho, E. J. G.; Gonzalez, R.; Nunez, L. S.; Cristian Vergara, M.; Baez, J. T.; Alonzo, H.; Pastelin, C. B. S.; Salinas, R. G.; Obiols, A. Q.; Chavez, N.; Ordonez, A. B.; Argueta, S.; Quijivix, D.; Llerena, G. A. R.; Sierra-Zorita, R.; Arrieta, D.; Hidalgo, E. R.; Saenz, R.; Morales, I. E. M. R.; Calapaqui, W.; Quezada, I.; Arredondo, G.. - In: RHEUMATOLOGY. - ISSN 1462-0324. - 64:2(2025), pp. 597-606. [10.1093/rheumatology/keae128]
Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: Results from the COVAD study
Sebastiani M.;
2025-01-01
Abstract
Objectives: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. Methods: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI, and hospitalizations among patients with IIMs. Results: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3%). The median age was 44 years [interquartile range (IQR) 21], 77.4% were female, and 182 BIs (12.9%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95% CI = 1.24-2.64, and HR = 3.79, 95% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0% vs AIRDs = 1.8%, nrAIDs = 2.2% and HCs = 0.9%), intensive care unit admission (IIMs = 2.2% vs AIRDs = 0.6%, nrAIDs and HCs = 0%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1% vs AIRDs = 25.8%, nrAIDs = 14.6% and HCs = 12.8%) and had more hospitalization (IIMs = 7.7% vs AIRDs = 4.6%, nrAIDs = 1.1% and HCs = 1.5%). Conclusion: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
