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SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: Results from the COVID-19 Global Rheumatology Alliance provider registry
Objective While COVID-19 vaccination prevents severe infections, poor immunogenicity in immunocompromised people threatens vaccine effectiveness. We analysed the clinical characteristics of patients with rheumatic disease who developed breakthrough COVID-19 after vaccination against SARS-CoV-2. Methods We included people partially or fully vaccinated against SARS-CoV-2 who developed COVID-19 between 5 January and 30 September 2021 and were reported to the Global Rheumatology Alliance registry. Breakthrough infections were defined as occurring ≥14 days after completion of the vaccination series, specifically 14 days after the second dose in a two-dose series or 14 days after a single-dose vaccine. We analysed patients%27 demographic and clinical characteristics and COVID-19 symptoms and outcomes. Results SARS-CoV-2 infection was reported in 197 partially or fully vaccinated people with rheumatic disease (mean age 54 years, 77%25 female, 56%25 white). The majority (n=140/197, 71%25) received messenger RNA vaccines. Among the fully vaccinated (n=87), infection occurred a mean of 112 (±60) days after the second vaccine dose. Among those fully vaccinated and hospitalised (n=22, age range 36-83 years), nine had used B cell-depleting therapy (BCDT), with six as monotherapy, at the time of vaccination. Three were on mycophenolate. The majority (n=14/22, 64%25) were not taking systemic glucocorticoids. Eight patients had pre-existing lung disease and five patients died. Conclusion More than half of fully vaccinated individuals with breakthrough infections requiring hospitalisation were on BCDT or mycophenolate. Further risk mitigation strategies are likely needed to protect this selected high-risk population. ©
Astra Zeneca; Janssen; Johnson and Johnson; Moderna; pfizer biontech
antirheumatic agents; COVID-19; vaccination abatacept; antimalarial agent; antirheumatic agent; azathioprine; belimumab; chloroquine; colchicine; cyclophosphamide; cyclosporine; disease modifying antirheumatic drug; glucocorticoid; hydroxychloroquine; Janus kinase inhibitor; leflunomide; methotrexate; mycophenolate mofetil; mycophenolic acid; prednisone; RNA vaccine; salazosulfapyridine; SARS-CoV-2 vaccine; tacrolimus; tumor necrosis factor inhibitor; ustekinumab; acute kidney failure; adult; adult respiratory distress syndrome; aged; Article; B lymphocyte; breakthrough infection; chronic kidney failure; clinical feature; comorbidity; coronavirus disease 2019; coughing; death; demography; diabetes mellitus; disease activity; drug efficacy; dyspnea; female; fever; high risk population; hospitalization; human; human cell; humoral immunity; hypertension; invasive ventilation; lung disease; lymphocyte depletion; major clinical study; malaise; male; monotherapy; myalgia; myositis; noninvasive ventilation; obesity; outcome assessment; outcomes research; psoriatic arthritis; register; repeated drug dose; rheumatic disease; rheumatoid arthritis; rheumatology; secondary infection; sepsis; Severe acute respiratory syndrome coronavirus 2; Sjoegren syndrome; spondylarthritis; symptom; systemic lupus erythematosus; systemic sclerosis; vaccination; vasculitis; complication; middle aged; prevention and control; rheumatic disease; rheumatology; very elderly; Adult; Aged; Aged, 80 and over; COVID-19; COVID-19 Vaccines; Female; Humans; Male; Middle Aged; Registries; Rheumatic Diseases; Rheumatology; SARS-CoV-2
Generically Dependent Continuant
RDF description of SARS-CoV-2 breakthrough infections among vaccinated individuals with rheumatic disease: Results from the COVID-19 Global Rheumatology Alliance provider registry - http://orbis.uaslp.mx/vivo/individual/scopus10227
Article
National Institutes of Health, NIH; National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIAMS: P30 AR070253, P30 AR072577, R01 AR077607; Amgen; Bristol-Myers Squibb, BMS; Eli Lilly and Company; Pfizer; Novartis; Sanofi; Gilead Sciences; Rheumatology Research Foundation, RRF; Meso Scale Diagnostics, MSD; Janssen Pharmaceuticals; School of Public Health, University of California Berkeley, UCB; Manchester Biomedical Research Centre, BRC; UCB Pharma: K24 AR074534, P30 AR070155; National Institute for Health and Care Research, NIHR; UCLH Biomedical Research Centre, NIHR BRC
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