Rohit Aggarwal1, Latika Gupta2,3,4,5, Leonardo Santos Hoff6, Naveen Ravichandran7, Samuel Katsuyuki Shinjo8, Jessica Day9,10,11, Parikshit Sen12, Jucier Gonçalves Junior8, James B Lilleker13,14, Mrudula Joshi15, Vishwesh Agarwal16, Sinan Kardes17, Minchul Kim18, Marcin Milchert19, Ashima Makol20, Tamer Gheita21, Babur Salim22, Tsvetelina Velikova23, Abraham Edgar Gracia-Ramos24, Ioannis Parodis25,26, Albert Selva O'Callaghan27, Elena Nikiphorou28,29, Ai Lyn Tan30,31, Tulika Chatterjee18, Lorenzo Cavagna32,33, Miguel A Saavedra34, Nelly Ziade35,36, Johannes Knitza37, Masataka Kuwana38, Arvind Nune39, Oliver Distler40, Döndü Üsküdar Cansu41, Lisa Traboco42, Suryo Angorro Kusumo Wibowo43, Erick Adrian Zamora Tehozol44, Jorge Rojas Serrano45, Ignacio García-De La Torre46, Chris Wincup47,48, John D Pauling49,50, Hector Chinoy13,51,52, Vikas Agarwal7. 1. Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 2. Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. drlatikagupta@gmail.com. 3. Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. drlatikagupta@gmail.com. 4. Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, WV10 0QP, UK. drlatikagupta@gmail.com. 5. City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK. drlatikagupta@gmail.com. 6. School of Medicine, Universidade Potiguar (UnP), Natal, Brazil. 7. Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. 8. Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. 9. Department of Rheumatology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia. 10. Walter and Eliza Hall Institute of Medical Research, Parkville, VIC, 3052, Australia. 11. Department of Medical Biology, University of Melbourne, Parkville, VIC, 3052, Australia. 12. Maulana Azad Medical College, 2-Bahadurshah Zafar Marg, New Delhi, Delhi, 110002, India. 13. Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK. 14. Neurology, Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Salford, UK. 15. Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India. 16. Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India. 17. Department of Medical Ecology and Hydroclimatology, Istanbul Faculty of Medicine, Istanbul University, Capa-Fatih, 34093, Istanbul, Turkey. 18. Center for Outcomes Research, Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA. 19. Department of Internal Medicine, Rheumatology, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, ul Unii Lubelskiej 1, 71-252, Szczecin, Poland. 20. Division of Rheumatology, Mayo Clinic, Rochester, MN, USA. 21. Rheumatology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt. 22. Rheumatology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan. 23. Department of Clinical Immunology, Medical Faculty, University Hospital "Lozenetz", Sofia University St. Kliment Ohridski, 1 Kozyak Str., 1407, Sofia, Bulgaria. 24. Department of Internal Medicine, General Hospital, National Medical Center, La Raza", Instituto Mexicano del Seguro Social, Av. Jacaranda S/N, Col. La Raza, Del. Azcapotzalco, 02990, Mexico City, Mexico. 25. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. 26. Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. 27. Internal Medicine Department, Vall D'hebron General Hospital, Universitat Autonoma de Barcelona, 08035, Barcelona, Spain. 28. Centre for Rheumatic Diseases, King's College London, London, UK. 29. Rheumatology Department, King's College Hospital, London, UK. 30. NIHR Leeds Biomedical Research Centre, Leeds Teaching Hospitals Trust, Leeds, UK. 31. Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK. 32. Department of Rheumatology, Fondazione I.R.C.C.S. Policlinico San Matteo, Pavia, Italy. 33. Rheumatology Unit, Dipartimento di Medicine Interna e Terapia Medica, Università degli studi di Pavia, Lombardy, Pavia, Italy. 34. Departamento de Reumatología Hospital de Especialidades Dr. Antonio Fraga Mouret, Centro Médico Nacional La Raza, IMSS, Mexico City, Mexico. 35. Rheumatology Department, Saint-Joseph University, Beirut, Lebanon. 36. Rheumatology Department, Hotel-Dieu de France Hospital, Beirut, Lebanon. 37. Medizinische Klinik 3-Rheumatologie und Immunologie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany. 38. Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8602, Japan. 39. Southport and Ormskirk Hospitals NHS Trust, Southport, PR8 6PN, UK. 40. Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 41. Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, 26480, Eskişehir, Turkey. 42. Philippine Rheumatology Association, St Luke's Medical Center-Global City, Taguig, Philippines. 43. Rheumatology Division, Department of Internal Medicine, Fakultas Kedokteran, Universitas Indonesia, Jakarta, Indonesia. 44. Rheumatology, Medical Care and Research, Centro Medico Pensiones Hospital, Instituto Mexicano del Seguro Social Delegación Yucatán, Yucatán, Mexico. 45. Rheumatologist and Clinical Investigator, Interstitial Lung Disease and Rheumatology Unit, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico. 46. Departamento de Inmunología y Reumatología, Hospital General de Occidente and University of Guadalajara, Guadalajara, Jalisco, Mexico. 47. Department of Rheumatology, Division of Medicine, Rayne Institute, University College London, London, UK. 48. Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, UK. 49. Bristol Medical School Translational Health Sciences, University of Bristol, Bristol, UK. 50. Department of Rheumatology, North Bristol NHS Trust, Bristol, UK. 51. National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK. 52. Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK.
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.
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.
Authors: Ana C Medeiros-Ribeiro; Nadia E Aikawa; Carla G S Saad; Emily F N Yuki; Tatiana Pedrosa; Solange R G Fusco; Priscila T Rojo; Rosa M R Pereira; Samuel K Shinjo; Danieli C O Andrade; Percival D Sampaio-Barros; Carolina T Ribeiro; Giordano B H Deveza; Victor A O Martins; Clovis A Silva; Marta H Lopes; Alberto J S Duarte; Leila Antonangelo; Ester C Sabino; Esper G Kallas; Sandra G Pasoto; Eloisa Bonfa Journal: Nat Med Date: 2021-07-30 Impact factor: 53.440
Authors: Sebastian Eduardo Sattui; Jean W Liew; Jonathan S Hausmann; Julia F Simard; Jeffrey A Sparks; Kevin Kennedy; Emily Sirotich; Michael Putman; Tarin T Moni; Akpabio Akpabio; Deshiré Alpízar-Rodríguez; Francis Berenbaum; Inita Bulina; Richard Conway; Aman Dev Singh; Eimear Duff; Karen L Durrant; Tamer A Gheita; Catherine L Hill; Richard A Howard; Bimba F Hoyer; Evelyn Hsieh; Lina El Kibbi; Adam Kilian; Alfred Hyoungju Kim; David F L Liew; Chieh Lo; Bruce Miller; Serena Mingolla; Michal Nudel; Candace A Palmerlee; Jasvinder A Singh; Namrata Singh; Manuel Francisco Ugarte-Gil; John Wallace; Kristen J Young; Suleman Bhana; Wendy Costello; Rebecca Grainger; Pedro M Machado; Philip C Robinson; Paul Sufka; Zachary S Wallace; Jinoos Yazdany; Carly Harrison; Maggie Larché; Mitchell Levine; Gary Foster; Lehana Thabane; Lisa G Rider Journal: RMD Open Date: 2021-09
Authors: Richard Conway; Alyssa A Grimshaw; Maximilian F Konig; Michael Putman; Alí Duarte-García; Leslie Yingzhijie Tseng; Diego M Cabrera; Yu Pei Eugenia Chock; Huseyin Berk Degirmenci; Eimear Duff; Bugra Han Egeli; Elizabeth R Graef; Akash Gupta; Patricia Harkins; Bimba F Hoyer; Arundathi Jayatilleke; Shangyi Jin; Christopher Kasia; Aneka Khilnani; Adam Kilian; Alfred H J Kim; Chung Mun Alice Lin; Candice Low; Laurie Proulx; Sebastian E Sattui; Namrata Singh; Jeffrey A Sparks; Herman Tam; Manuel F Ugarte-Gil; Natasha Ung; Kaicheng Wang; Leanna M Wise; Ziyi Yang; Kristen J Young; Jean W Liew; Rebecca Grainger; Zachary S Wallace; Evelyn Hsieh Journal: Arthritis Rheumatol Date: 2022-03-28 Impact factor: 15.483
Authors: Jonathan S Hausmann; Kevin Kennedy; Julia F Simard; Jean W Liew; Jeffrey A Sparks; Tarin T Moni; Carly Harrison; Maggie J Larché; Mitchell Levine; Sebastian E Sattui; Teresa Semalulu; Gary Foster; Salman Surangiwala; Lehana Thabane; Richard P Beesley; Karen L Durrant; Elsa F Mateus; Serena Mingolla; Michal Nudel; Candace A Palmerlee; Dawn P Richards; David F L Liew; Catherine L Hill; Suleman Bhana; Wendy Costello; Rebecca Grainger; Pedro M Machado; Philip C Robinson; Paul Sufka; Zachary S Wallace; Jinoos Yazdany; Emily Sirotich Journal: Lancet Rheumatol Date: 2021-07-22