Predictors of Hospitalization in Breakthrough COVID-19 among Fully Vaccinated Individuals with Immune-Mediated Rheumatic Diseases: Data from SAFER-Study

被引：1

作者：

Calderaro, Debora Cerqueira ^{[1
]}

Valim, Valeria ^{[2
]}

Ferreira, Gilda Aparecida ^{[1
]}

Machado, Ketty Lysie Libardi Lira ^{[2
]}

Ribeiro, Priscila Dias Cardoso ^{[3
]}

Ribeiro, Sandra Lucia Euzebio ^{[4
]}

Sartori, Natalia Sarzi ^{[5
]}

de Rezende, Rodrigo Poubel Vieira ^{[6
]}

de Melo, Ana Karla Guedes ^{[7
]}

Cruz, Vitor Alves ^{[8
]}

Vieira, Adah Sophia Rodrigues ^{[9
]}

Kakehasi, Adriana Maria ^{[1
]}

de Landa, Aline Teixeira ^{[10
]}

Burian, Ana Paula Neves ^{[11
]}

Peixoto, Flavia Maria Matos Melo Campos ^{[3
]}

Telles, Camila Maria Paiva Franca ^{[4
]}

do Espirito Santo, Rafaela Cavalheiro ^{[5
,12
]}

Baptista, Katia Lino ^{[6
]}

de Oliveira, Yasmin Gurtler Pinheiro ^{[2
]}

Magalhaes, Vanessa de Oliveira ^{[3
]}

de Lima, Raquel Lima ^{[4
]}

Biegelmeyer, Erika ^{[3
]}

Lorencini, Pietra Zava ^{[2
]}

Teixeira-Carvalho, Andrea ^{[13
]}

dos Reis-Neto, Edgard Torres ^{[3
]}

Sato, Emilia Inoue ^{[3
]}

Pinheiro, Marcelo de Medeiros ^{[3
]}

Monticielo, Odirlei Andre ^{[5
]}

de Souza, Viviane Angelina ^{[10
]}

Xavier, Ricardo Machado ^{[5
]}

Pileggi, Gecilmara Salviato ^{[3
]}

机构：

[1] Univ Fed Minas Gerais UFMG, Fac Med, Locomotor Syst Dept, BR-30130100 Belo Horizonte, MG, Brazil

[2] Hosp Univ Cassiano Antonio Moraes HUCAM, Univ Fed Espirito St UFES, BR-29041295 Vitoria, ES, Brazil

[3] Univ Fed Sao Paulo UNIFESP, Escola Paulista Med EPM, BR-04023062 Sao Paulo, SP, Brazil

[4] Univ Fed Amazonas UFAM, Escola Med, BR-69067005 Manaus, AM, Brazil

[5] Univ Fed Rio Grande do Sul UFRGS, Hosp Clin Porto Alegre, Serv Reumatol, BR-90010150 Porto Alegre, RS, Brazil

[6] Univ Fed Fluminense UFF, BR-24020140 Rio De Janeiro, RJ, Brazil

[7] Univ Fed Paraiba UFPB, Hosp Univ Lauro Wanderley, BR-58051900 Joao Pessoa, PB, Brazil

[8] Univ Fed Goias UFG, Fac Med, BR-74690900 Goiania, GO, Brazil

[9] Univ Fortaleza UNIFOR, Hosp Geral Fortaleza HGF, BR-60150160 Fortaleza, CE, Brazil

[10] Univ Fed Juiz de Fora, Fac Med, Dept Clin Med, BR-36036900 Juiz De Fora, MG, Brazil

[11] Ctr Referencias Imunobiol Especiais CRIE, Secretaria Saude Estado Espirito Santo, BR-29050360 Vitoria, ES, Brazil

[12] Klaipeda Univ, Hlth Res & Innovat Sci Ctr, LT-92294 Klaipeda, Lithuania

[13] Fdn Oswaldo Cruz FIOCRUZ Minas, Inst Rene Rachou, BR-30190002 Belo Horizonte, MG, Brazil

来源：

VACCINES | 2024年 / 12卷 / 09期

关键词：

COVID-19; vaccines; health disparities; breakthrough COVID-19 infections; rheumatic diseases; vaccination of immune compromised patients; COVID-19 vaccine booster shot;

D O I：

10.3390/vaccines12091031

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

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 p-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; p = 0.002) and treatment with corticosteroids (OR: 2.94; CI: 1.02-8.49; p = 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; p = 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.

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