The following is a summary of “Characteristics and risk factors of COVID-19 breakthrough infections in Idiopathic Inflammatory Myopathies: Results from the COVAD study,” published in the March 2024 issue of Rheumatology by Hoff et al.
Researchers conducted a retrospective study to investigate the prevalence, features, and susceptibility factors of COVID-19 breakthrough infections (BIs) among individuals with idiopathic inflammatory myopathies (IIM), utilizing data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.
They distributed a validated patient self-reporting e-survey through the COVAD study group to gather information on COVID-19 infection and vaccination in 2022. BIs were defined as instances of COVID-19 occurring ≥14 days after receiving two vaccine doses. They conducted comparisons of BI characteristics and severity among individuals with IIMs, other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HC). Multivariable Cox regression models were employed to assess the risk factors associated with BI, severe BI, and hospitalizations among those with IIMs.
The results showed that among the 9449 BIs that occurred in 1447 (15.3%), with a median age of 44 years (IQR 21), 77.4% were female. Among 1406 IIMs, there were 182 BIs (12.9%). Multivariable Cox regression among IIMs revealed that age was a protective factor for BIs (HR=0.98, 95%CI=0.97–0.99). Hydroxychloroquine and sulfasalazine use were identified as risk factors (HR=1.81, 95%CI=1.24–2.64 and HR=3.79, 95%CI=1.69–8.42). Glucocorticoid use was a risk factor for severe BI (HR=3.61, 95% CI=1.09–11.8). Non-White ethnicity (HR=2.61, 95%CI=1.03–6.59) was associated with a higher risk of hospitalization. Patients with IIMs, compared with other groups, required more supplemental oxygen therapy (IIM=6.0% vs. AIRD=1.8%, nrAID=2.2%, and HC=0.9%), intensive care unit admission (IIM=2.2% vs. AIRD=0.6%, nrAID and HC=0%), advanced treatment with antiviral or monoclonal antibodies (IIM=34.1% vs. AIRD=25.8%, nrAID=14.6%, and HC=12.8%), and experienced more hospitalizations (IIM=7.7% vs. AIRD=4.6%, nrAID=1.1%, and HC=1.5%).
Investigators concluded that IIM patients, especially older ones on immunosuppressants, are more likely to experience severe COVID-19 vaccine BIs.
Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keae128/7617840