Correlates of breakthrough COVID-19 in vaccinated patients with systemic sclerosis: survival analysis from a multicentre international patient-reported survey

Ahmed S, Gupta L, Kuwana M, Pauling JD, Day J, Ravichandran N, Joshi M, Parodis I, Sen P, Jagtap K, Nikiphorou E, Saha S, Agarwal V, Chatterjee T, Lilleker JB, Kardes S, Milchert M, Gheita T, Salim B, Velikova T, Gracia-Ramos AE, Tan AL, Nune A, Cavagna L, Saavedra MA, Shinjo SK, Ziade N, Knitza J, Distler O, Wibowo SAK, Barman B, Singh YP, Ranjan R, Jain A, Pandya SC, Pilania RK, Sharma A, Manoj MM, Gupta V, Kavadichanda CG, Patro PS, Ajmani S, Phatak S, Goswami RP, Chowdhury AC, Mathew AJ, Shenoy P, Asranna A, Bommakanti KT, Shukla A, Pande AR, Chandwar K, Cansu DÜ, Wincup C, Del Papa N, Sambataro G, Fabiola A, Govoni M, Parisi S, Bocci EB, Sebastiani GD, Fusaro E, Sebastiani M, Quartuccio L, Franceschini F, Sainaghi PP, Orsolini G, De Angelis R, Danielli MG, Venerito V, Traboco LS, Serrano JR, La Torre IGD, Tehozol EAZ, Loarce-Martos J, Prieto-González S, Gil-Vila A, Gonzalez RA, Yoshida A, Nakashima R, Sato S, Kimura N, Kaneko Y, Tomaras S, Gromova MA, Aharonov O, Hmamouchi I, Hoff LS, Giannini M, Maurier F, Campagne J, Meyer A, Nagy-Vincze M, Langguth D, Limaye V, Needham M, Srivastav N, Hudson M, Landon-Cardinal O, Shaharir SS, Zuleta WGR, Silva JAP, Fonseca JE, Zimba O, Chinoy H, Aggarwal R, Agarwal V, Makol A (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 44

Pages Range: 89-97

Journal Issue: 1

DOI: 10.1007/s00296-023-05433-z

Abstract

This study aimed to assess the incidence, predictors, and outcomes of breakthrough infection (BI) following coronavirus disease (COVID-19) vaccination in patients with systemic sclerosis (SSc), a risk group associated with an immune-suppressed state and high cardiopulmonary disease burden. Cross-sectional data from fully vaccinated respondents with SSc, non-SSc autoimmune rheumatic diseases (AIRDs), and healthy controls (HCs) were extracted from the COVAD database, an international self-reported online survey. BI was defined according to the Centre for Disease Control definition. Infection-free survival was compared between the groups using Kaplan–Meier curves with log-rank tests. Cox proportional regression was used to assess the association between BI and age, sex, ethnicity, and immunosuppressive drugs at the time of vaccination. The severity of BI in terms of hospitalization and requirement for oxygen supplementation was compared between groups. Of 10,900 respondents, 6836 fulfilled the following inclusion criteria: 427 SSc, 2934 other AIRDs, and 3475 HCs. BI were reported in 6.3% of SSc, 6.9% of non-SSc AIRD, and 16.1% of HCs during a median follow-up of 100 (IQR: 60–137) days. SSc had a lower risk for BI than HC [hazard ratio (HR): 0.56 (95% CI 0.46–0.74)]. BIs were associated with age [HR: 0.98 (0.97–0.98)] but not ethnicity or immunosuppressive drugs at the time of vaccination. Patients with SSc were more likely to have asymptomatic COVID-19, but symptomatic patients reported more breathlessness. Hospitalization [SSc: 4 (14.8%), HCs: 37 (6.6%), non-SSc AIRDs: 32(15.8%)] and the need for oxygenation [SSc: 1 (25%); HC: 17 (45.9%); non-SSc AIRD: 13 (40.6%)] were similar between the groups. The incidence of BI in SSc was lower than that in HCs but comparable to that in non-SSc AIRDs. The severity of BI did not differ between the groups. Advancing age, but not ethnicity or immunosuppressive medication use, was associated with BIs.

Authors with CRIS profile

Involved external institutions

Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) India (IN) Mayo Clinic United States (USA) (US) Salford Royal Hospital United Kingdom (GB) Kalinga Institute of Industrial Technology (KIIT) India (IN) University of Manchester United Kingdom (GB) Istanbul University / İstanbul Üniversitesi Turkey (TR) The Royal Wolverhampton NHS Trust / Royal Wolverhampton Hospitals NHS Trust United Kingdom (GB) Maulana Azad Medical College (MAMC) India (IN) Pomeranian Medical University / Pomorski Uniwersytet Medyczny w Szczecinie (PMU) Poland (PL) King Edward Memorial Hospital and Seth G.S. Medical College / கிங் எட்வர்ட் நினைவு மருத்துவமனை,राजा एड्वर्ड स्मारक रुग्णालय व सेठ गोवर्धनदास सुंदरदास वैद्यकीय महाविद्यालय India (IN) King’s College London United Kingdom (GB) Mymensingh Medical College / ময়মনসিংহ মেডিকেল কলেজ Bangladesh (BD) Fauji Foundation Hospital Pakistan (PK) Instituto Mexicano del Seguro Social Mexico (MX) NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU) United Kingdom (GB) Mahatma Gandhi Mission Medical College and Hospital India (IN) Southport and Ormskirk Hospital NHS Trust United Kingdom (GB) University of Bristol United Kingdom (GB) University of Illinois at Chicago United States (USA) (US) Royal Melbourne Hospital (RMH) Australia (AU) Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospital India (IN) Karolinska University Hospital / Karolinska Universitetssjukhuset Sweden (SE) Universitätsspital Zürich (USZ) Switzerland (CH) Università degli Studi di Pavia Italy (IT) Centro Medico Nacional Siglo XXI Mexico (MX) University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Université Saint-Joseph (USJ) / جامعة القديس يوسف / Սուրբ Ժոզեֆի համալսարան Lebanon (LB) University of Indonesia (UI) / Universitas Indonesia Indonesia (ID) Sofia University "St. Kliment Ohridski" / Софийски университет "Св. Климент Охридски" Bulgaria (BG) University of Pittsburgh United States (USA) (US)

How to cite

APA:

Ahmed, S., Gupta, L., Kuwana, M., Pauling, J.D., Day, J., Ravichandran, N.,... Makol, A. (2024). Correlates of breakthrough COVID-19 in vaccinated patients with systemic sclerosis: survival analysis from a multicentre international patient-reported survey. Rheumatology International, 44(1), 89-97. https://dx.doi.org/10.1007/s00296-023-05433-z

MLA:

Ahmed, Sakir, et al. "Correlates of breakthrough COVID-19 in vaccinated patients with systemic sclerosis: survival analysis from a multicentre international patient-reported survey." Rheumatology International 44.1 (2024): 89-97.

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