Breakthrough SARS-CoV-2 infection in fully vaccinated patients with systemic lupus erythematosus: results from the COVID-19 Vaccination in Autoimmune Disease (COVAD) study

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2024年8月13日

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Leonardo Palazzo,
Julius Lindblom,
Emelie Kihlgren Olsson,
Elena Nikiphorou,
Chris Wincup,
Sreoshy Saha,
Syahrul Sazliyana Shaharir,
Wanruchada Katchamart,
Phonpen Akarawatcharangura Goo,
Lisa Traboco,
Yi-Ming Chen,
James B. Lilleker,
Arvind Nune,
John D. Pauling,
Vishwesh Agarwal,
Dey Dzifa,
Carlos Enrique Toro Gutiérrez,
Carlo V. Caballero-Uribe,
Hector Chinoy,
Bhupen Barman,
Yogesh Preet Singh,
Rajiv Ranjan,
Avinash Jain,
Sapan C. Pandya,
Rakesh Kumar Pilania,
Aman Sharma,
Manesh Manoj M,
Vikas Gupta,
Chengappa G. Kavadichanda,
Pradeepta Sekhar Patro,
Sajal Ajmani,
Sanat Phatak,
Rudra Prosad Goswami,
Abhra Chandra Chowdhury,
Ashish Jacob Mathew,
Padnamabha Shenoy,
Ajay Asranna,
Keerthi Talari Bommakanti,
Anuj Shukla,
Arun Kumar R. Pandey,
Kunal Chandwar,
Sinan Kardes,
Döndü Üsküdar Cansu,
Minchul Kim,
Ashima Makol,
Tulika Chatterjee,
John D. Pauling,
Chris Wincup,
Lorenzo Cavagna,
Nicoletta Del Papa,
Gianluca Sambataro,
Atzeni Fabiola,
Marcello Govoni,
Simone Parisi,
Elena Bartoloni Bocci,
Gian Domenico Sebastiani,
Enrico Fusaro,
Marco Sebastiani,
Luca Quartuccio,
Franco Franceschini,
Pier Paolo Sainaghi,
Giovanni Orsolini,
Rossella De Angelis,
Maria Giovanna Danielli,
Vincenzo Venerito,
Marcin Milchert,
Lisa S. Traboco,
Suryo Anggoro Kusumo Wibowo,
Erick Adrian Zamora Tehozol,
Jorge Rojas Serrano,
Ignacio García-De La Torre,
Jesús Loarce-Martos,
Sergio Prieto-González,
Albert Gil-Vila,
Raquel Aranega Gonzalez,
Masataka Kuwana,
Akira Yoshida,
Ran Nakashima,
Shinji Sato,
Naoki Kimura,
Yuko Kaneko,
Johannes Knitza,
Stylianos Tomaras,
Margarita Aleksandrovna Gromova,
Or Aharonov,
Tamer A. Gheita,
Ihsane Hmamouchi,
Leonardo Santos Hoff,
Margherita Giannini,
Francois Maurier,
Julien Campagne,
Alain Meyer,
Melinda Nagy-Vincze,
Daman Langguth,
Vidya Limaye,
Merrilee Needham,
Nilesh Srivastav,
Marie Hudson,
Océane Landon-Cardinal,
Syahrul Sazliyana Shaharir,
Wilmer Gerardo Rojas Zuleta,
José António Pereira Silva,
João Eurico Fonseca,
Olena Zimba,
Vikas Agarwal,
Latika Gupta,
Ioannis Parodis

摘要

Objective

To determine the occurrence of breakthrough COVID-19 infections (BIs) in patients with systemic lupus erythematosus (SLE) compared with patients with other rheumatic autoimmune diseases (rAIDs), patients with non-rheumatic autoimmune diseases (nrAIDs), and healthy controls (HCs).

Methods

The study was based on data from 7035 fully vaccinated respondents to the online COVAD questionnaire with SLE (N = 852), rAIDs (N = 3098), or nrAIDs (N = 414), and HCs (N = 2671). BI was defined as COVID-19 infection occurring in individuals vaccinated with ≥ 2 doses (or 1 dose of J&J) ≥ 14 days after vaccination and not after 6 months since the last vaccine dose. Data were analysed using linear and logistic regression models.

Results

A total of 91/852 (10.7%) SLE patients reported at least one BI. The frequency of BIs in SLE patients was comparable to that among HCs (277/2671; p = 0.847) and patients with nrAID (39/414; p = 0.552) but higher than that among patients with other rAIDs (235/3098; p = 0.005). No demographic factors or treatments were associated with BIs in SLE patients (p ≥ 0.05 for all). Joint pain was more frequent in SLE patients than in HCs (odds ratio [OR]: 3.38; 95% confidence interval [CI]: 1.89–6.04; p < 0.001) or nrAID patients (OR: 2.44; 95% CI: 1.04–5.75; p = 0.041). Patient with SLE did not report a higher frequency of hospitalisation or need for advanced treatment for COVID-19 infection compared with disease controls and HCs, respectively.

Conclusion

COVID-19 vaccination conferred similar protection against COVID-19 infection in terms of frequency and severity in patients with SLE to that reported by healthy individuals.