Predictors of Hospitalization in Breakthrough COVID-19 among Fully Vaccinated Individuals with Immune-Mediated Rheumatic Diseases: Data from SAFER-Study
Breakthrough COVID-19 (occurring in fully vaccinated people) has been described. Data on its characteristics among immune-mediated rheumatic disease (IMRD) patients are scarce. This study describes breakthrough COVID-19 occurring in IMRD patients participating in the SAFER-study, a Brazilian multicentric cohort evaluating the safety, effectiveness, and immunogenicity of SARS-CoV-2 vaccines in patients with autoimmune diseases. A descriptive analysis of the population and a binary logistic regression model were performed to evaluate the predictors of COVID-19-related hospitalization. A <i>p</i>-value < 0.05 was significant. The included 160 patients were predominantly females (83.1%), with a mean (SD) age of 40.23 (13.19) years. The patients received two (19%), three (70%), or four (11%) vaccine doses. The initial two-dose series was mainly with ChAdOx1 (Oxford/AstraZeneca) (58%) or BBIBP-CorV (Sinopharm-Beijing) (34%). The first booster (n = 150) was with BNT162b2 (BioNtech/Fosun Pharma/Pfizer) (63%) or ChAdOx1 (29%). The second booster (n = 112) was with BNT162b2 (40%) or ChAdOx1 (26%). The COVID-19 hospitalization rate was 17.5%. IMRD moderate/high activity (OR: 5.84; CI: 1.9-18.5; <i>p</i> = 0.002) and treatment with corticosteroids (OR: 2.94; CI: 1.02-8.49; <i>p</i> = 0.0043) were associated with higher odds of hospitalization, while increasing the number of vaccine doses was protective (OR: 0.37; CI: 0.15-0.9; <i>p</i> = 0.032). These findings, along with previous reassuring results about the safety of the COVID-19 vaccines, argue in favor of booster vaccination in IMRD patients.
Authors
- Viviane Angelina de Souza (ORCID: https://orcid.org/0000-0001-6386-3776)
- Aline Teixeira de Landa
- Erika Biegelmeyer (ORCID: https://orcid.org/0000-0003-4978-040X)
- Natália Sarzi Sartori (ORCID: https://orcid.org/0000-0002-4316-0771)
- Emília Inoue Sato (ORCID: https://orcid.org/0000-0001-8540-014X)
- Gilda Aparecida Ferreira (ORCID: https://orcid.org/0000-0002-1352-7261)
- Rafaela Cavalheiro do Espírito Santo (ORCID: https://orcid.org/0000-0002-5518-3479)
- Débora Cerqueira Calderaro (ORCID: https://orcid.org/0000-0001-5535-3223)
- Valéria Valim (ORCID: https://orcid.org/0000-0002-0625-1308)
- Andréa Teixeira‐Carvalho (ORCID: https://orcid.org/0000-0003-2814-5183)
- Vítor Alves Cruz (ORCID: https://orcid.org/0000-0002-3073-2929)
- Ketty Lysie Libardi Lira Machado (ORCID: https://orcid.org/0000-0003-2545-6795)
- Vanessa de Oliveira Magalhães
- Camila Maria Paiva França Telles (ORCID: https://orcid.org/0000-0001-9168-9816)
- Gecilmara Salviato Pileggi (ORCID: https://orcid.org/0000-0003-0054-7754)
- Priscila Dias Cardoso Ribeiro (ORCID: https://orcid.org/0000-0003-2598-810X)
- Odirlei André Monticielo (ORCID: https://orcid.org/0000-0003-0720-2097)
- Adriana María Kakehasi (ORCID: https://orcid.org/0000-0001-9411-7493)
- Flávia Maria Matos Melo Campos Peixoto
- Ana Paula Neves Burian (ORCID: https://orcid.org/0000-0002-5056-5523)
- Pietra Zava Lorencini (ORCID: https://orcid.org/0000-0003-2072-1705)
- Adah Sophia Rodrigues Vieira (ORCID: https://orcid.org/0000-0002-8090-9606)
- Marcelo M. Pinheiro (ORCID: https://orcid.org/0000-0002-1896-8322)
- Sandra Lúcia Euzébio Ribeiro (ORCID: https://orcid.org/0000-0002-4777-8659)
- Rodrigo Poubel Vieira de Rezende (ORCID: https://orcid.org/0000-0002-1623-259X)
- Ricardo Machado Xavier (ORCID: https://orcid.org/0000-0001-6570-4533)
- Edgard Torres dos Reis-Neto (ORCID: https://orcid.org/0000-0003-0657-4825)
- Kátia Lino (ORCID: https://orcid.org/0000-0002-6134-8495)
- Raquel Lima de Lima
- Yasmin Gurtler Pinheiro de Oliveira (ORCID: https://orcid.org/0000-0002-2049-5368)
- Ana Karla Guedes de Melo
Institutions
- Universidade Federal de Juiz de Fora (BR)
- Universidade Federal de Minas Gerais (BR)
- Universidade Federal do Rio Grande do Sul (BR)
- Universidade Federal Fluminense (BR)
- Universidade Federal da Paraíba (BR)
- Universidade de Fortaleza (BR)
- Klaipėda University (LT)
- Hospital de Clínicas de Porto Alegre (BR)
- Hospital Universitário Lauro Wanderley (BR)
- Secretaria da Saúde (BR)
- Hospital Geral de Fortaleza (BR)
- Universidade Federal do Espírito Santo (BR)
- Fundação Oswaldo Cruz (BR)
- Universidade Federal do Amazonas (BR)
- Universidade Federal de Goiás (BR)
- Universidade Federal de São Paulo (BR)
Publication Details
- Journal
- Vaccines
- Published
- 2024-09-09
- DOI
- https://doi.org/10.3390/vaccines12091031
- Citations
- 2
- Primary Topic
- SARS-CoV-2 and COVID-19 Research
- Type
- article
- Field-Weighted Citation Impact
- 0.78
Funders
- Universidade Federal do Amazonas
- Universidade Federal do Rio Grande do Sul
- Universidade Federal de Goiás
- Universidade Federal de Minas Gerais
- Universidade Federal de Juiz de Fora
- Universidade Federal Fluminense
- Universidade Federal da Paraíba