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, IG.; Colunga-Pedraza, IJ.; Merayo-Chalico, J.; Chibuzo, OC.; Katchamart, W.; Goo, PA.; Shumnalieva, R.; El Kibbi, L.; Halabi, H.; Vaidya, B.; Shaharir, SS.; Hasan, ATMT.; Dey, D.; Gutierrez, CET.; Caballero-Uribe, CV.; Lilleker, JB.; Salim, B.; Gheita, T.; Chatterjee, T.; Distler, O.; Saavedra, MA.; Chinoy, H.; Aggarwal, R.; Gupta, L.

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

All Authors

Hoff, LS.

Ravichandran, N.

Sen, P.

Day, J.

Joshi, M.

Nune, A.

Nikiphorou, E.

Saha, S.

Tan, AL.

Shinjo, SK.

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LTHT Author

Tan, Ai Lyn

LTHT Department

NIHR Leeds Biomedical Research Centre

Publication Date

2025

Item Type

Journal Article
Research Support, Non-U.S. Gov't

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.