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PREVALENCE, CHARACTERISTICS, AND PREDICTORS OF BREAKTHROUGH COVID-19 INFECTIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS : DATA FROM THE COVID-19 VACCINATION IN AUTOIMMUNE DISEASE (COVAD) STUDY

Ravichandran, N. (author)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Clinical Immunology and Rheumatology, Lucknow, India
Parodis, Ioannis, 1981- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Karolinska Institute, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden; Örebro University, Department of Rheumatology, Faculty of Medicine and Health, Örebro, Sweden
Gupta, L. (author)
The Royal Wolverhampton NHS Trust, Department of Rheumatology, Wolverhampton, United Kingdom; The University of 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 The University of Manchester, Manchester, United Kingdom
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Katsuyuki Shinjo, S. (author)
University of São Paulo, Division of Rheumatology, Faculdade de Medicina FMUSP, Sao Paulo, Brazil
Ziade, N. (author)
Saint Joseph University of Beirut, Rheumatology Department, Bayrut, Lebanon; Hôtel-Dieu de France, Rheumatology Department, Bayrut, Lebanon
Milchert, M. (author)
Pomeranian Medical University, Department of Internal Medicine, Rheumatology, Diabetology, Geriatrics and Clinical Immunology, Szczecin, Poland
Cavagna, L. (author)
The University of Pavia, Rheumatology Unit, Dipartimento di Medicine Interna e Terapia Medica, Pavia, Italy
Tan, A. L. (author)
University of Leeds, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, United Kingdom; Trust Headquarters, Leeds Teaching Hospitals NHS Trust, NIHR Leeds Biomedical Research Centre, Leeds, United Kingdom
Lilleker, J. B. (author)
The University of 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 The University of Manchester, Manchester, United Kingdom; Salford Royal, Manchester Centre for Clinical Neurosciences, Salford, United Kingdom
Nune, A. (author)
Southport & Ormskirk Hospital NHS Trust, Southport, United Kingdom
Pauling, J. (author)
University of Bristol, Bristol Medical School Translational Health Sciences, Bristol, United Kingdom; North Bristol NHS Trust, Department of Rheumatology, Bristol, United Kingdom
Wincup, C. (author)
Rayne Building, UCL, Department of Rheumatology, Division of Medicine, London, United Kingdom; University College London, Centre for Adolescent Rheumatology Versus Arthritis, London, United Kingdom
Katchamart, W. (author)
Faculty of Medicine Siriraj Hospital, Mahidol University, Division of Rheumatology, Department of Medicine, Bangkok, Thailand
Goo, P. A. (author)
Queen Savang Vadhana Memorial Hospital, Department of Medicine, Tambon Si Racha, Thailand
Study, C. (author)
Karolinska Institute, Division of Rheumatology, Department of Medicine Solna, Stockholm, Sweden; The Royal Wolverhampton NHS Trust, Department of Rheumatology, Wolverhampton, United Kingdom
Chinoy, H. (author)
The University of 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 The University of Manchester, Manchester, United Kingdom; Manchester University NHS Foundation Trust, National Institute for Health Research Manchester Biomedical Research Centre, Manchester, United Kingdom; Salford Royal, Department of Rheumatology, Salford, United Kingdom
Aggarwal, R. (author)
University of Pittsburgh School of Medicine, Division of Rheumatology and Clinical Immunology, Pittsburgh, United States of America
Agarwal, V. (author)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Clinical Immunology and Rheumatology, Lucknow, India
Nikiphorou, E. (author)
King’s College London, Centre for Rheumatic Diseases, London, United Kingdom; King’s College Hospital, Rheumatology Department, London, United Kingdom
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 (creator_code:org_t)
HighWire Press, 2023
2023
English.
In: Annals of the Rheumatic Diseases. - : HighWire Press. - 0003-4967 .- 1468-2060. ; 82:Suppl. 1, s. 56-56
Related links:
https://doi.org/10.1...
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https://urn.kb.se/re...
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  • Journal article (other academic/artistic)
Abstract Subject headings
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  • Background: Global data on COVID-19 breakthrough infections (BI) following COVID-19 vaccination among autoimmune rheumatic diseases (AIRDs) and especially rheumatoid arthritis (RA) is scarce.Objectives: This study aimed to examine the characteristics of COVID-19 BI among patients with RA and compare them with AIRDs and healthy controls (HCs).Methods: A global e-survey, January-May 2022, collected data on COVID-19 vaccination, and BI in patients with RA, AIRDs, non-rheumatic autoimmune disease (nrAIDs), and HCs. BI was defined as infection after both primary or booster vaccine doses. Severe BI was defined as the need for hospitalization, including intensive unit care, oxygen therapy, or advanced treatment in the form of monoclonal antibodies.Results: Of the 9595 vaccinated respondents of the e-survey, 3224 (33.6%) reported COVID-19. One BI was reported in 323/1802 (17.9%) patients with RA, 584/3869 (15.0%) patients with other AIRDs, and 467/3435 (13.5%) HCs. Similarly, second BI was reported by 280 (8.6%); 42 (2.3%) among RA, 90 (2.3%) among other AIRDs, and 124 (3.6%) among HCs.The prevalence of first BI in patients with RA was higher than that in those with AIRDs (OR=1.2; 95%CI=1.1-1.4; p=0.001) and HCs (OR=1.4; 95%CI=1.2-1.6; p<0.001), but similar to nrAIDs (p=0.783). The prevalence of second BI was lower in patients with RA than in HCs (OR=0.6; 95%CI=0.4-0.9; p=0.012) and nrAIDs (OR=0.4; 95%CI=0.2-0.7; p=0.004), but similar to AIRDs (p=0.991). When compared with HCs, patients with RA reported significantly higher joint pain, hospitalizations, and need for advanced treatment at first BI. Patients with RA from very high HDI countries had lower hazard of first BI than those from high HDI countries (HR=0.026; 95%CI=0.001-0.6; p=0.027). Rituximab use predicted more frequent hospitalization (OR=3.4; 95%CI=1.3-11.4; p=0.045) and severe BI (OR=3.0; 95%CI=1.2-7.3; p=0.014).Conclusion: Nearly one in five patients with RA reported BI. BI prevalence was higher in patients with RA and of higher severity than in HCs. Country HDI was an important determinant of outcomes, suggesting potential impact of environmental dynamics, local vaccination policy, and syndemic constructs that merit further exploration. Rituximab use predicted more frequent hospitalizations and more severe BI.

Subject headings

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

Keyword

Rheumatoid arthritis
COVID
Vaccination/Immunization

Publication and Content Type

vet (subject category)
art (subject category)

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