Characteristics and outcomes of SARS-CoV-2 breakthrough infections among double-vaccinated and triple-vaccinated patients with inflammatory rheumatic diseases

被引：10

作者：

Hasseli, Rebecca ^{[1
,2
]}

Richter, Jutta ^{[3
,4
]}

Hoyer, Bimba Franziska ^{[5
]}

Lorenz, Hanns-Martin ^{[6
]}

Pfeil, Alexander ^{[7
]}

Regierer, Anne Constanze ^{[8
]}

Schmeiser, Tim ^{[9
]}

Strangfeld, Anja ^{[8
,10
,24
]}

Voll, Reinhard E. ^{[11
,12
]}

Krause, Andreas ^{[13
]}

Reckert, Sabine ^{[14
]}

Graessler, Anett ^{[15
]}

Saar, Petra ^{[16
]}

Kapelle, Andreas ^{[17
]}

Backhaus, Marina ^{[18
]}

Blank, Norbert ^{[6
]}

Henes, Joerg ^{[19
,20
]}

Osiek, Silke ^{[21
]}

Knothe, Anna ^{[2
]}

Hoese, Guido ^{[22
]}

Brandt-Juergens, Jan ^{[23
]}

Maltzahn, Anja

Specker, Christof ^{[25
]}

Mueller-Ladner, Ulf

Schulze- Koops, Hendrik ^{[26
]}

机构：

[1] Univ Hosp Munster, Dept Internal Med D, Sect Rheumatol & Clin Immunol, Munster, Germany

[2] Justus Liebig Univ Giessen, Dept Rheumatol & Clin Immunol, Campus Kerckhoff, Giessen, Germany

[3] Heinrich Heine Univ Duesseldorf, Univ Hosp Duesseldorf, Med Fac, Clin Rheumatol, Dusseldorf, Germany

[4] Heinrich Heine Univ Duesseldorf, Univ Hosp Duesseldorf, Med Fac, Hiller Res Ctr, Dusseldorf, Germany

[5] Univ Med Ctr Schleswig Holstein Campus, Clin Internal Med 1, Rheumatol & Clin Immunol, Kiel, Germany

[6] Univ Hosp Heidelberg, Div Rheumatol, Dept Med 5, Heidelberg, Germany

[7] Univ Hosp Jena, Dept Internal Med 3, Jena, Germany

[8] German Rheumatism Res Ctr, Epidemiol Unit, Berlin, Germany

[9] Private Practice Rheumatol Veedel Cologne, Rheumatol, Cologne, Germany

[10] Charite, Dept Rheumatol & Clin Immunol, Berlin, Germany

[11] Univ Freiburg, Fac Med, Med Ctr, Dept Rheumatol & Clin Immunol, Freiburg, Germany

[12] Univ Freiburg, Fac Med, Med Ctr, Ctr Chron Immunodeficiency, Freiburg, Germany

[13] Immanuel Hosp, Dept Rheumatol Clin Immunol & Osteol, Berlin, Germany

[14] Rheumatol, Potsdam, Germany

[15] Rheumatol, Pirna, Germany

[16] Endokrinologikum, Rheumatol, Frankfurt, Germany

[17] Rheumatol, Hoyerswerda, Germany

[18] Acad Hosp Charite Berlin, Dept Internal Med, Pk Klin Weissensee, Rheumatol & Clin Immunol, Berlin, Germany

[19] Univ Hosp Tuebingen, Ctr Interdisciplinary Clin Immunol, Rheumatol & Autoinflammat Dis INDIRA, Tubingen, Germany

[20] Univ Hosp Tuebingen, Dept Internal Med Oncol 2, Haematol Rheumatol & Clin Immunol, Tubingen, Germany

[21] Dialysezentrum, Rheumatol, Schweinfurt, Germany

[22] Rheumatol, Stadthagen, Germany

[23] Rheumatol, Berlin, Germany

[24] Rheumatol, Gottingen, Germany

[25] KEM Kliniken Essen Mitte, Dept Rheumatol & Clin Immunol, Essen, Germany

[26] Ludwig Maximilians Univ Munchen, Dept Internal Medicine4, Div Rheumatol & Clin Immunol, Munich, Germany

来源：

RMD OPEN | 2023年 / 9卷 / 02期

关键词：

COVID-19; vaccination; antirheumatic agents; inflammation;

D O I：

10.1136/rmdopen-2023-002998

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectiveTo analyse the clinical profile of SARS-CoV-2 breakthrough infections in at least double-vaccinated patients with inflammatory rheumatic diseases (IRDs).MethodsData from the physician-reported German COVID-19-IRD registry collected between February 2021 and July 2022 were analysed. SARS-CoV-2 cases were stratified according to patients' vaccination status as being not vaccinated, double-vaccinated or triple-vaccinated prior to SARS-CoV-2 infection and descriptively compared. Independent associations between demographic and disease features and outcome of breakthrough infections were estimated by multivariable logistic regression.ResultsIn total, 2314 cases were included in the analysis (unvaccinated n=923, double-vaccinated n=551, triple-vaccinated n=803, quadruple-vaccinated n=37). SARS-CoV-2 infections occurred after a median of 151 (range 14-347) days in patients being double-vaccinated, and after 88 (range 14-270) days in those with a third vaccination. Hospitalisation was required in 15% of unvaccinated, 8% of double-vaccinated and 3% of triple-vaccinated/quadruple-vaccinated patients (p<0.001). Mortality was 2% in unvaccinated, 1.8% in the double-vaccinated and 0.6% in triple-vaccinated patients. Compared with unvaccinated patients, double-vaccinated (OR 0.43, 95% CI 0.29 to 0.62) and triple-vaccinated (OR 0.13, 95% CI 0.08 to 0.21) patients showed a significant lower risk of COVID-19-related hospitalisation. Using multivariable analysis, the third vaccination was significantly associated with a lower risk for COVID-19-related death (OR 0.26; 95% CI 0.01 to 0.73).ConclusionsOur cross-sectional data of COVID-19 infections in patients with IRD showed a significant reduction of hospitalisation due to infection in double-vaccinated or triple-vaccinated patients compared with those without vaccination and even a significant reduction of COVID-19-related deaths in triple-vaccinated patients. These data strongly support the beneficial effect of COVID-19 vaccination in patients with IRD.

引用

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