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

• Published in: Vaccines (Basel) Vol. 12; no. 9; p. 1031
• Main Authors: Calderaro, Débora Cerqueira, Valim, Valéria, Ferreira, Gilda Aparecida, Machado, Ketty Lysie Libardi Lira, Ribeiro, Priscila Dias Cardoso, Ribeiro, Sandra Lúcia Euzébio, Sartori, Natalia Sarzi, de Rezende, Rodrigo Poubel Vieira, de Melo, Ana Karla Guedes, Cruz, Vitor Alves, Vieira, Adah Sophia Rodrigues, Kakehasi, Adriana Maria, de Landa, Aline Teixeira, Burian, Ana Paula Neves, Peixoto, Flávia Maria Matos Melo Campos, Telles, Camila Maria Paiva França, do Espírito Santo, Rafaela Cavalheiro, Baptista, Katia Lino, de Oliveira, Yasmin Gurtler Pinheiro, Magalhães, Vanessa de Oliveira, de Lima, Raquel Lima, Biegelmeyer, Erika, Lorencini, Pietra Zava, Teixeira-Carvalho, Andréa, Dos Reis-Neto, Edgard Torres, Sato, Emília Inoue, Pinheiro, Marcelo de Medeiros, Monticielo, Odirlei André, de Souza, Viviane Angelina, Xavier, Ricardo Machado, Pileggi, Gecilmara Salviato
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.09.2024; MDPI
• Subjects: Antigens; Arthritis; Autoimmune diseases; breakthrough COVID-19 infections; Connective tissue diseases; Corticoids; Corticosteroids; COVID-19; COVID-19 vaccines; Diabetes; health disparities; Hospitalization; Immunization; Immunogenicity; Infections; Inflammatory bowel disease; Inflammatory diseases; Informed consent; Kidney diseases; Mortality; Patient outcomes; Pharmaceuticals; Psoriasis; Regression models; Rheumatic diseases; Rheumatology; Severe acute respiratory syndrome coronavirus 2; vaccination of immune compromised patients; Vaccines; Brazil; COVID-19; COVID-19 vaccines; health disparities; rheumatic diseases; COVID-19 vaccine booster shot; vaccination of immune compromised patients; breakthrough COVID-19 infections
• ISSN: 2076-393X; 2076-393X
• DOI: 10.3390/vaccines12091031

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 -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; = 0.002) and treatment with corticosteroids (OR: 2.94; CI: 1.02-8.49; = 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; = 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.