Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study

Hoff LS, Ravichandran N, Sen P, Day J, Joshi M, Nune A, Nikiphorou E, Saha S, Tan AL, Shinjo SK, Ziade N, Velikova T, Milchert M, Jagtap K, Parodis I, Gracia-Ramos AE, Cavagna L, Kuwana M, Knitza J, Chen YM, Makol A, Agarwal V, Patel A, Pauling JD, Wincup C, Barman B, Tehozol EAZ, Serrano JR, Torre IGDL, Colunga-Pedraza IJ, Merayo-Chalico J, Chibuzo OC, Katchamart W, Goo PA, Shumnalieva R, El Kibbi L, Halabi H, Vaidya B, Shaharir SS, Hasan AT, Dey D, Gutiérrez CET, Caballero-Uribe CV, Lilleker JB, Salim B, Gheita T, Chatterjee T, Distler O, Saavedra MA, Chinoy H, Agarwal V, Aggarwal R, Gupta L, Singh YP, Ranjan R, Jain A, Pandya SC, Pilania RK, Sharma A, Manesh Manoj M, 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, Gaur PS, Mamadapur M, Ghodke A, Chandwar K, Kadam E, Fazal ZZ, Kardeş S, Cansu DÜ, Ylldlrlm R, Gasparyan AY, Giannini M, Maurier F, Campagne J, Meyer A, 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, Grignaschi S, Giollo A, Andreoli L, Lini D, Alluno A, Iannone F, Fornaro M, Traboco LS, Wibowo SAK, Loarce-Martos J, Prieto-González S, Aranega R, Yoshida A, Nakashima R, Sato S, Kimura N, Kaneko Y, Gono T, Tomaras S, Proft FN, Holzer MT, Gromova MA, Aharonov MO, Nagy-Vincze M, Griger Z, Schrieber K, Hmamouchi I, El Bouchti PI, Baba Z, Ima-Edomwonyi U, Dedeke I, Airenakho E, Madu NH, Yerima A, Olaosebikan H, Becky A, Koussougbo OD, Palalane E, Langguth D, Limaye V, Needham M, Srivastav N, Hudson M, Landon-Cardinal O, Zuleta WGR, Arbeláez Á, Cajas J, Silva JAP, Fonseca JE, Zimba O, Bohdana D, So H, Ugarte-Gil MF, Chinchay L, Bernaola JP, Pimentel V, Fathi HM, Mohammed RHA, Harifi G, Fuentes-Silva Y, Cabriza K, Losanto J, Colaman N, Cachafeiro-Vilar A, Bautista GG, Ho EJG, González R, Nunez LS, Cristian Vergara M, Báez JT, Alonzo H, Pastelin CBS, Salinas RG, Obiols AQ, Chávez N, Ordóñez AB, Argueta S, Quijivix D, Llerena GAR, Sierra-Zorita R, Arrieta D, Hidalgo ER, Saenz R, Morales IEM, Calapaqui W, Quezada I, Arredondo G (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Book Volume: 64

Pages Range: 597-606

Journal Issue: 2

DOI: 10.1093/rheumatology/keae128

Abstract

OBJECTIVES: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study. METHODS: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI ,and hospitalizations among patients with IIMs. RESULTS: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3%). The median age was 44 years [interquartile range (IQR) 21], 77.4% were female, and 182 BIs (12.9%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95% CI = 1.24-2.64, and HR = 3.79, 95% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0% vs AIRDs = 1.8%, nrAIDs = 2.2% and HCs = 0.9%), intensive care unit admission (IIMs = 2.2% vs AIRDs = 0.6%, nrAIDs and HCs = 0%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1% vs AIRDs = 25.8%, nrAIDs = 14.6% and HCs = 12.8%) and had more hospitalization (IIMs = 7.7% vs AIRDs = 4.6%, nrAIDs = 1.1% and HCs = 1.5%). CONCLUSION: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.

Authors with CRIS profile

Involved external institutions

Siriraj Hospital Thailand (TH) Queen Savang Vadhana Memorial Hospital / โรงพยาบาลสมเด็จพระบรมราชเทวี ณ ศรีราชา Thailand (TH) University Hospital St. Ivan Rilski Bulgaria (BG) King Faisal Specialist Hospital & Research Centre Saudi Arabia (SA) National Center for Rheumatic Diseases (NCRD) Nepal (NP) University of Malaya (UM) / Universiti Malaya Malaysia (MY) Enam Medical College & Hospital (EMCH) / এনাম মেডিকেল কলেজ ও হাসপাতাল Bangladesh (BD) University of Ghana Ghana (GH) Instituto Mexicano del Seguro Social Mexico (MX) Instituto Nacional de Enfermedades Respiratorias Mexico (MX) Universidad de Guadalajara (UDEG) Mexico (MX) Hospital Universitario Dr José Eleuterio Gonzalez Mexico (MX) Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Mexico (MX) University of Nigeria Nigeria (NG) Pontifical Xavierian University / Pontificia Universidad Javeriana Colombia (CO) Universidad del Norte Colombia (CO) University of Manchester United Kingdom (GB) Fauji Foundation Hospital Pakistan (PK) Universidade Potiguar (UnP) Brazil (BR) Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGIMS) India (IN) Maulana Azad Medical College (MAMC) India (IN) Royal Melbourne Hospital (RMH) Australia (AU) Byramjee Jeejeebhoy Government Medical College & Sassoon General Hospital India (IN) Southport and Ormskirk Hospital NHS Trust United Kingdom (GB) King’s College London United Kingdom (GB) Mymensingh Medical College / ময়মনসিংহ মেডিকেল কলেজ Bangladesh (BD) NIHR Leeds Musculoskeletal Biomedical Research Unit (LMBRU) United Kingdom (GB) University of São Paulo / Universidade de São Paulo (USP) Brazil (BR) Université Saint-Joseph (USJ) / جامعة القديس يوسف / Սուրբ Ժոզեֆի համալսարան Lebanon (LB) Sofia University "St. Kliment Ohridski" / Софийски университет "Св. Климент Охридски" Bulgaria (BG) 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) Karolinska University Hospital / Karolinska Universitetssjukhuset Sweden (SE) Università degli Studi di Pavia Italy (IT) Taichung Veterans General Hospital Taiwan (TW) Mayo Clinic United States (USA) (US) Mahatma Gandhi Mission Medical College and Hospital India (IN) University of Virginia (UVA) United States (USA) (US) University of Bristol United Kingdom (GB) University College London (UCL) United Kingdom (GB) University of Illinois at Chicago United States (USA) (US) Universitätsspital Zürich (USZ) Switzerland (CH) Centro Medico Nacional Siglo XXI Mexico (MX) University of Pittsburgh United States (USA) (US)

How to cite

APA:

Hoff, L.S., Ravichandran, N., Sen, P., Day, J., Joshi, M., Nune, A.,... Arredondo, G. (2025). Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study. Rheumatology, 64(2), 597-606. https://doi.org/10.1093/rheumatology/keae128

MLA:

Hoff, Leonardo Santos, et al. "Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study." Rheumatology 64.2 (2025): 597-606.

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