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Sökning: id:"swepub:oai:DiVA.org:oru-111582" > BREAKTHROUGH SARS-C...

BREAKTHROUGH SARS-COV-2 INFECTION IN FULLY VACCINATED PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS : RESULTS FROM THE COVID-19 VACCINATION IN AUTOIMMUNE DISEASE (COVAD) STUDY

Olsson, E. Kihlgren (författare)
Karolinska Institutet and Karolinska University Hospital, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden
Ravichandran, N. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India
Nikiphorou, E. (författare)
King’s College London, Centre for Rheumatic Diseases, London, United Kingdom; King’s College Hospital, Rheumatology Department, London, United Kingdom
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Lindblom, J. (författare)
Karolinska Institutet and Karolinska University Hospital, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden
Saha, S. (författare)
Mymensingh Medical College, Mymensingh Medical College, Mymensingh, Bangladesh
Shaharir, S. S. (författare)
Universiti Kebangsaan Malaysia, Faculty of Medicine, Cheras, Kuala Lumpur, Malaysia
Katchamart, W. (författare)
Faculty of Medicine Siriraj Hospital, Mahidol University, Division of Rheumatology, Department of Medicine, Bangkok, Thailand
Goo, P. A. (författare)
Queen Savang Vadhana Memorial Hospital, Department of Medicine, Chonburi, Thailand
Traboco, L. (författare)
St. Luke’s Medical Center-Global City, Department of Medicine, Section of Rheumatology, Taguig, Philippines
Chen, Y. M. (författare)
Taichung Veterans General Hospital, Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung City, Taiwan, Republic of China; Taichung Veterans General Hospital, Department of Medical Research, Taichung, Taiwan, Republic of China
Jagtap, K. (författare)
Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Seth Gordhandhas Sunderdas Medical College and King Edwards Memorial Hospital, Mumbai, Maharashtra, India
Lilleker, J. B. (författare)
The University of Manchester, Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, United Kingdom; Salford Royal NHS Foundation Trust, Manchester Centre for Clinical Neurosciences, Salford, United Kingdom
Nune, A. (författare)
Southport and Ormskirk Hospital NHS Trust, Southport and Ormskirk Hospital NHS Trust, Southport, United Kingdom
Pauling, J. (författare)
Bristol Medical School Translational Health Sciences, Bristol Medical School Translational Health Sciences, Bristol, United Kingdom; North Bristol NHS Trust, Department of Rheumatology, Bristol, United Kingdom
Wincup, C. (författare)
Rayne Institute, University College London, Department of Rheumatology, Division of Medicine, London, United Kingdom; Centre for Adolescent Rheumatology Versus Arthritis at UCL, UCLH, GOSH, London, United Kingdom
Agarwal, V. (författare)
Mahatma Gandhi Mission Medical College, Mahatma Gandhi Mission Medical College, Navi Mumbai, Maharashtra, India
Dzifa, D. (författare)
University of Ghana Medical School, College of Health Sciences, Korle-Bu, Rheumatology Unit, Department of Medicine and Therapeutics, Accra, Ghana
Toro Gutierrez, C. E. (författare)
Pontificia Universidad Javeriana Cali, General Director, Reference Center for Osteoporosis, Rheumatology and Dermatology, Cali, Colombia
Vinicio Caballero, C. (författare)
Hospital Universidad del Norte, Department of Medicine, Barranquilla, Atlantico, Colombia
Chinoy, H. (författare)
The University of Manchester, Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, United Kingdom; Manchester University NHS Foundation Trust, The University of Manchester, National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom; Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Department of Rheumatology, Salford, United Kingdom
Aggarwal, R. (författare)
University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, Pennsylvania, United States of America
Gupta, L. (författare)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Clinical Immunology and Rheumatology, Lucknow, India; The University of Manchester, Manchester, Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester, United Kingdom; Royal Wolverhampton Hospitals NHS Trust, Department of Rheumatology, Wolverhampton, United Kingdom; Sandwell and West Birmingham Hospitals NHS Trust, City Hospital, Birmingham, United Kingdom
Parodis, Ioannis, 1981- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Karolinska Institutet and Karolinska University Hospital, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden; Örebro University, Department of Rheumatology, Faculty of Medicine and Health, Örebro, Sweden
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 (creator_code:org_t)
HighWire Press, 2023
2023
Engelska.
Ingår i: Annals of the Rheumatic Diseases. - : HighWire Press. - 0003-4967 .- 1468-2060. ; 82:Suppl. 1, s. 540-541
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
http://kipublication...
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  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
Abstract Ämnesord
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  • Background: Although many studies have been conducted on COVID-19 in recent years, there are still unanswered questions regarding breakthrough infections (BTIs), particularly in patients with systemic lupus erythematosus (SLE).Objectives: This study aimed to determine the occurrence of breakthrough COVID-19 infections in patients with SLE versus other autoimmune rheumatic diseases (AIRDs), non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs).Methods: The study was based on data from the COVAD questionnaire which amassed a total of 10,783 complete responses from patients with SLE, AIRD, or nrAIRD, and HCs. After exclusion of individuals who were unvaccinated, those who received one vaccine dose only, and those with uncertain responses regarding the vaccine doses, a total of 9,595 patients formed the study population of the present investigation. If a COVID-19 infection occurred after the initial two vaccine doses and at least one booster dose (at least three doses in total, herein termed full vaccination), it was considered a BTI. Data were analysed using multivariable regression models. Statistically significant results were denoted by p values <0.05.Results: A total of 7,016/9,595 (73.1%) individuals were fully vaccinated. Among those, 1,002 (14.2%) reported at least one BTI, and 166 (2.3%) reported at least two BTIs. Among SLE patients, 867/1,218 (71.2%) were fully vaccinated. Among fully vaccinated SLE patients, 137 (15.8%) reported at least one BTI while 28 (3.2%) reported at least two BTIs. BTI frequencies in fully vaccinated SLE patients were comparable to those of other AIRDs (OR: 1.0; 95% CI: 0.8–1.3; p=0.447) and nrAIDS (OR: 0.9; 95% CI: 0.6–1.3; p=0.856) but higher compared with HCs (OR: 1.2; 95% CI: 1.0–1.6; p=0.022).For SLE patients with three vaccine doses, 113/137 (82.5%) reported at least one BTI while the corresponding number for four vaccine doses was 24/137 (17.5%). Compared with HCs (OR: 10.6; 95% CI: 1.2–93.0; p=0.032) and other AIRDs (OR: 3.5; 95% CI: 1.08–11.5; p=0.036), SLE patients showed higher frequencies of hospitalisation.AID multimorbidity was associated with a 15-fold increased risk for a need of advanced treatment for COVID-19 (OR: 15.3; 95% CI: 2.6–88.2; p=0.002).Conclusion: COVID-19 BTIs occurred in nearly 1 every 6th fully vaccinated patient with SLE, and 20% more frequently in this patient population compared with fully vaccinated HCs. Moreover, BTIs in SLE patients were more severe compared with BTIs in HCs or patients with AIRDs other than SLE, resulting in a greater need for hospitalisation. AID multimorbidity contributed to a more severe COVID-19 BTI requiring advanced management. These insights call for greater attention to vaccination in the vulnerable group of SLE patients, with appropriate risk stratification towards optimised vaccination strategies.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

Nyckelord

COVID
Systemic lupus erythematosus
Vaccination/immunization

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