COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey

COVAD Study Group; Leonardo Santos Hoff; Naveen Ravichandran; Samuel Katsuyuki Shinjo; Jessica Day; Parikshit Sen; Jucier Gonçalves Junior; James B Lilleker; Mrudula Joshi; Vishwesh Agarwal; Sinan Kardes; Minchul Kim; Marcin Milchert; Ashima Makol; Tamer Gheita; Babur Salim; Tsvetelina Velikova; Abraham Edgar Gracia-Ramos; Ioannis Parodis; Albert Selva O'Callaghan; Elena Nikiphorou; Ai Lyn Tan; Tulika Chatterjee; Lorenzo Cavagna; Miguel A Saavedra; Nelly Ziade; Johannes Knitza; Masataka Kuwana; Arvind Nune; Oliver Distler; John D Pauling; Latika Gupta; et al

doi:10.1007/s00296-022-05229-7

COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey

COVAD Study Group , Leonardo Santos Hoff, Naveen Ravichandran, Samuel Katsuyuki Shinjo, Jessica Day, Parikshit Sen, Jucier Gonçalves Junior, James B Lilleker, Mrudula Joshi, Vishwesh Agarwal, Sinan Kardes, Minchul Kim, Marcin Milchert, Ashima Makol, Tamer Gheita, Babur Salim, Tsvetelina Velikova, Abraham Edgar Gracia-Ramos, Ioannis Parodis, Albert Selva O'CallaghanElena Nikiphorou, Ai Lyn Tan, Tulika Chatterjee, Lorenzo Cavagna, Miguel A Saavedra, Nelly Ziade, Johannes Knitza, Masataka Kuwana, Arvind Nune, Oliver Distler, John D Pauling, Latika Gupta^*, et al

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

18 Citations (Scopus)

Abstract

Objectives:
We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs).

Methods:
This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis.

Results:
Among 10,900 respondents [42 (30–55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4–0.8, and OR = 0.3, 95% CI 0.2–0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2–5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3–5.3 in BI]. In a multivariate regression analysis, age 30–60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5–1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1–2.7).

Conclusions:
Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.

Original language	English
Pages (from-to)	47-58
Number of pages	12
Journal	Rheumatology International
Volume	43
Issue number	1
Early online date	22 Oct 2022
DOIs	https://doi.org/10.1007/s00296-022-05229-7
Publication status	Published - 1 Jan 2023

Bibliographical note

Publisher Copyright:
© 2022. The Author(s).

UN SDGs

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

SDG 3 Good Health and Well-being

Keywords

Adult
Female
Animals
Humans
Middle Aged
COVID-19 Vaccines
Cross-Sectional Studies
Breakthrough Infections
Simian Acquired Immunodeficiency Syndrome
COVID-19/epidemiology
Myositis
Autoimmune Diseases/epidemiology
Vaccination
Self Report
Immunosuppressive Agents/adverse effects

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COVAD Study Group , Hoff, L. S., Ravichandran, N., Shinjo, S. K., Day, J., Sen, P., Junior, J. G., Lilleker, J. B., Joshi, M., Agarwal, V., Kardes, S., Kim, M., Milchert, M., Makol, A., Gheita, T., Salim, B., Velikova, T., Gracia-Ramos, A. E., Parodis, I., ... al, E. (2023). COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey. Rheumatology International, 43(1), 47-58. https://doi.org/10.1007/s00296-022-05229-7

COVAD Study Group ; Hoff, Leonardo Santos ; Ravichandran, Naveen et al. / COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls : a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey. In: Rheumatology International. 2023 ; Vol. 43, No. 1. pp. 47-58.

@article{f851801c6dce4a478e59782692af6302,

title = "COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey",

abstract = "Objectives: We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs). Methods: This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis. Results: Among 10,900 respondents [42 (30–55) years, 74\%-females, 45\%-Caucasians] HCs were (47\%), SAIDs (42\%) and IIMs (11\%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2\%-IIM vs 10.5\%-SAIDs vs 14.6\%-HC; OR = 0.6, 95\% CI 0.4–0.8, and OR = 0.3, 95\% CI 0.2–0.5, respectively). BIs were uncommon (1.4\%-IIM; 1.9\%-SAIDs; 3.2\%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18\%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30\%) vs 59 (8\%), OR = 2.5, 95\% CI 1.2–5.1 before vaccination, and 3 (18\%) vs 9 (5\%), OR = 2.6, 95\% CI 1.3–5.3 in BI]. In a multivariate regression analysis, age 30–60 years was associated with a lower odds of BI (OR = 0.7, 95\% CI 0.5–1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95\% CI 1.1–2.7). Conclusions: Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.",

keywords = "Adult, Female, Animals, Humans, Middle Aged, COVID-19 Vaccines, Cross-Sectional Studies, Breakthrough Infections, Simian Acquired Immunodeficiency Syndrome, COVID-19/epidemiology, Myositis, Autoimmune Diseases/epidemiology, Vaccination, Self Report, Immunosuppressive Agents/adverse effects",

author = "\{COVAD Study Group\} and Hoff, \{Leonardo Santos\} and Naveen Ravichandran and Shinjo, \{Samuel Katsuyuki\} and Jessica Day and Parikshit Sen and Junior, \{Jucier Gon{\c c}alves\} and Lilleker, \{James B\} and Mrudula Joshi and Vishwesh Agarwal and Sinan Kardes and Minchul Kim and Marcin Milchert and Ashima Makol and Tamer Gheita and Babur Salim and Tsvetelina Velikova and Gracia-Ramos, \{Abraham Edgar\} and Ioannis Parodis and O'Callaghan, \{Albert Selva\} and Elena Nikiphorou and Tan, \{Ai Lyn\} and Tulika Chatterjee and Lorenzo Cavagna and Saavedra, \{Miguel A\} and Nelly Ziade and Johannes Knitza and Masataka Kuwana and Arvind Nune and Oliver Distler and Pauling, \{John D\} and Latika Gupta and et al",

note = "Publisher Copyright: {\textcopyright} 2022. The Author(s).",

year = "2023",

month = jan,

day = "1",

doi = "10.1007/s00296-022-05229-7",

language = "English",

volume = "43",

pages = "47--58",

journal = "Rheumatology International",

issn = "0172-8172",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "1",

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COVAD Study Group , Hoff, LS, Ravichandran, N, Shinjo, SK, Day, J, Sen, P, Junior, JG, Lilleker, JB, Joshi, M, Agarwal, V, Kardes, S, Kim, M, Milchert, M, Makol, A, Gheita, T, Salim, B, Velikova, T, Gracia-Ramos, AE, Parodis, I, O'Callaghan, AS, Nikiphorou, E, Tan, AL, Chatterjee, T, Cavagna, L, Saavedra, MA, Ziade, N, Knitza, J, Kuwana, M, Nune, A, Distler, O, Pauling, JD, Gupta, L & al, E 2023, 'COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey', Rheumatology International, vol. 43, no. 1, pp. 47-58. https://doi.org/10.1007/s00296-022-05229-7

COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey. / COVAD Study Group ; Hoff, Leonardo Santos; Ravichandran, Naveen et al.
In: Rheumatology International, Vol. 43, No. 1, 01.01.2023, p. 47-58.

Research output: Contribution to journal › Article (Academic Journal) › peer-review

TY - JOUR

T1 - COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls

T2 - a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey

AU - COVAD Study Group

AU - Hoff, Leonardo Santos

AU - Ravichandran, Naveen

AU - Shinjo, Samuel Katsuyuki

AU - Day, Jessica

AU - Sen, Parikshit

AU - Junior, Jucier Gonçalves

AU - Lilleker, James B

AU - Joshi, Mrudula

AU - Agarwal, Vishwesh

AU - Kardes, Sinan

AU - Kim, Minchul

AU - Milchert, Marcin

AU - Makol, Ashima

AU - Gheita, Tamer

AU - Salim, Babur

AU - Velikova, Tsvetelina

AU - Gracia-Ramos, Abraham Edgar

AU - Parodis, Ioannis

AU - O'Callaghan, Albert Selva

AU - Nikiphorou, Elena

AU - Tan, Ai Lyn

AU - Chatterjee, Tulika

AU - Cavagna, Lorenzo

AU - Saavedra, Miguel A

AU - Ziade, Nelly

AU - Knitza, Johannes

AU - Kuwana, Masataka

AU - Nune, Arvind

AU - Distler, Oliver

AU - Pauling, John D

AU - Gupta, Latika

AU - al, et

PY - 2023/1/1

Y1 - 2023/1/1

N2 - Objectives: We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs). Methods: This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis. Results: Among 10,900 respondents [42 (30–55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4–0.8, and OR = 0.3, 95% CI 0.2–0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2–5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3–5.3 in BI]. In a multivariate regression analysis, age 30–60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5–1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1–2.7). Conclusions: Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.

AB - Objectives: We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs). Methods: This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis. Results: Among 10,900 respondents [42 (30–55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4–0.8, and OR = 0.3, 95% CI 0.2–0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2–5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3–5.3 in BI]. In a multivariate regression analysis, age 30–60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5–1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1–2.7). Conclusions: Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs.

KW - Adult

KW - Female

KW - Animals

KW - Humans

KW - Middle Aged

KW - COVID-19 Vaccines

KW - Cross-Sectional Studies

KW - Breakthrough Infections

KW - Simian Acquired Immunodeficiency Syndrome

KW - COVID-19/epidemiology

KW - Myositis

KW - Autoimmune Diseases/epidemiology

KW - Vaccination

KW - Self Report

KW - Immunosuppressive Agents/adverse effects

U2 - 10.1007/s00296-022-05229-7

DO - 10.1007/s00296-022-05229-7

M3 - Article (Academic Journal)

C2 - 36271958

SN - 0172-8172

VL - 43

SP - 47

EP - 58

JO - Rheumatology International

JF - Rheumatology International

IS - 1

ER -

COVAD Study Group , Hoff LS, Ravichandran N, Shinjo SK, Day J, Sen P et al. COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey. Rheumatology International. 2023 Jan 1;43(1):47-58. Epub 2022 Oct 22. doi: 10.1007/s00296-022-05229-7