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

COVAD Study Group

doi:10.1093/rheumatology/keae128

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

COVAD Study Group

Department of Medicine And Therapeutics

Universidade Potiguar
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Maulana Azad Medical College
Royal Melbourne Hospital
Walter and Eliza Hall Institute of Medical Research
University of Melbourne
Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals
Southport and Ormskirk Hospital NHS Trust
King’s College London
King's College Hospital
Mymensingh Medical College
NIHR Leeds Biomedical Research Centre
University of Leeds, School of Medicine
University of São Paulo
Saint Joseph University
Hotel-Dieu de France Hospital
Sofia University St. Kliment Ohridski
Pomeranian Medical University in Szczecin
King Edward Memorial Hospital
Karolinska University Hospital
Örebro University
Instituto Mexicano del Seguro Social
University of Pavia
Nippon Medical School
Universitätsklinikum Erlangen
Taichung Veterans General Hospital
Mayo Clinic Rochester, MN
Mahatma Gandhi Mission Medical College
University of Virginia School of Medicine
Bristol Medical School
North Bristol NHS Trust
University College London
University College London
All India Institute of Medical Sciences
Instituto Nacional de Enfermedades Respiratorias
Universidad de Guadalajara
Hospital Universitario Dr. Jose Eleuterio Gonzalez
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
University of Nigeria
Siriraj Hospital
Queen Savang Vadhana Memorial Hospital
University Hospital “St. Ivan Rilski”
Specialized Medical Center
King Faisal Specialist Hospital and Research Centre
National Center for Rheumatic Diseases (NCRD)
Universiti Kebangsaan Malaysia
Enam Medical College and Hospital
Pontificia Universidad Javeriana
Hospital Universidad del Norte
Faculty of Biology, Medicine and Health
Salford Royal NHS Foundation Trust
Fauji Foundation Hospital
Cairo University
University of Illinois College of Medicine
University Hospital Zurich
IMSS
Manchester University NHS Foundation Trust
Northern Care Alliance NHS Group
University of Pittsburgh School of Medicine
Royal Wolverhampton Hospitals NHS Trust
Sandwell and West Birmingham Hospitals NHS Trust

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

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.

Original language	English
Pages (from-to)	597-606
Number of pages	10
Journal	Rheumatology
Volume	64
Issue number	2
DOIs	https://doi.org/10.1093/rheumatology/keae128
Publication status	Published - 1 Feb 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

COVID-19
autoimmune diseases
breakthrough infection
hospitalization
idiopathic inflammatory myopathies

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10.1093/rheumatology/keae128

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@article{7fe05a35228e4457ae12e6890f771ea5,

title = "Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: Results from the COVAD study",

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.",

keywords = "COVID-19, autoimmune diseases, breakthrough infection, hospitalization, idiopathic inflammatory myopathies",

author = "\{COVAD Study Group\} and Hoff, \{Leonardo Santos\} and Naveen Ravichandran and Parikshit Sen and Jessica Day and Mrudula Joshi and Arvind Nune and Elena Nikiphorou and Sreoshy Saha and Tan, \{Ai Lyn\} and Shinjo, \{Samuel Katsuyuki\} and Nelly Ziade and Tsvetelina Velikova and Marcin Milchert and Kshitij Jagtap and Ioannis Parodis and Gracia-Ramos, \{Abraham Edgar\} and Lorenzo Cavagna and Masataka Kuwana and Johannes Knitza and Chen, \{Yi Ming\} and Ashima Makol and Vishwesh Agarwal and Aarat Patel and Pauling, \{John D.\} and Chris Wincup and Bhupen Barman and Tehozol, \{Erick Adrian Zamora\} and Serrano, \{Jorge Rojas\} and Torre, \{Ignacio Garc{\'i}a De La\} and Colunga-Pedraza, \{Iris J.\} and Javier Merayo-Chalico and Chibuzo, \{Okwara Celestine\} and Wanruchada Katchamart and Goo, \{Phonpen Akarawatcharangura\} and Russka Shumnalieva and \{El Kibbi\}, Lina and Hussein Halabi and Binit Vaidya and Shaharir, \{Syahrul Sazliyana\} and Hasan, \{A. T.M.Tanveer\} and Dzifa Dey and Guti{\'e}rrez, \{Carlos Enrique Toro\} and Caballero-Uribe, \{Carlo V.\} and Lilleker, \{James B.\} and Babur Salim and Tamer Gheita and Tulika Chatterjee and Oliver Distler and Saavedra, \{Miguel A.\} and Hector Chinoy",

year = "2025",

month = feb,

day = "1",

doi = "10.1093/rheumatology/keae128",

language = "English",

volume = "64",

pages = "597--606",

journal = "Rheumatology",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies

T2 - Results from the COVAD study

AU - COVAD Study Group

AU - Hoff, Leonardo Santos

AU - Ravichandran, Naveen

AU - Sen, Parikshit

AU - Day, Jessica

AU - Joshi, Mrudula

AU - Nune, Arvind

AU - Nikiphorou, Elena

AU - Saha, Sreoshy

AU - Tan, Ai Lyn

AU - Shinjo, Samuel Katsuyuki

AU - Ziade, Nelly

AU - Velikova, Tsvetelina

AU - Milchert, Marcin

AU - Jagtap, Kshitij

AU - Parodis, Ioannis

AU - Gracia-Ramos, Abraham Edgar

AU - Cavagna, Lorenzo

AU - Kuwana, Masataka

AU - Knitza, Johannes

AU - Chen, Yi Ming

AU - Makol, Ashima

AU - Agarwal, Vishwesh

AU - Patel, Aarat

AU - Pauling, John D.

AU - Wincup, Chris

AU - Barman, Bhupen

AU - Tehozol, Erick Adrian Zamora

AU - Serrano, Jorge Rojas

AU - Torre, Ignacio García De La

AU - Colunga-Pedraza, Iris J.

AU - Merayo-Chalico, Javier

AU - Chibuzo, Okwara Celestine

AU - Katchamart, Wanruchada

AU - Goo, Phonpen Akarawatcharangura

AU - Shumnalieva, Russka

AU - El Kibbi, Lina

AU - Halabi, Hussein

AU - Vaidya, Binit

AU - Shaharir, Syahrul Sazliyana

AU - Hasan, A. T.M.Tanveer

AU - Dey, Dzifa

AU - Gutiérrez, Carlos Enrique Toro

AU - Caballero-Uribe, Carlo V.

AU - Lilleker, James B.

AU - Salim, Babur

AU - Gheita, Tamer

AU - Chatterjee, Tulika

AU - Distler, Oliver

AU - Saavedra, Miguel A.

AU - Chinoy, Hector

PY - 2025/2/1

Y1 - 2025/2/1

N2 - 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.

AB - 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.

KW - COVID-19

KW - autoimmune diseases

KW - breakthrough infection

KW - hospitalization

KW - idiopathic inflammatory myopathies

UR - https://www.scopus.com/pages/publications/85217518077

U2 - 10.1093/rheumatology/keae128

DO - 10.1093/rheumatology/keae128

M3 - Article

C2 - 38430474

AN - SCOPUS:85217518077

SN - 1462-0324

VL - 64

SP - 597

EP - 606

JO - Rheumatology

JF - Rheumatology

IS - 2

ER -

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

Abstract

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Keywords

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