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

Palazzo, L.; Lindblom, J.; Kihlgren Olsson, E.; Nikiphorou, E.; Wincup, C.; Saha, S.; Shaharir, S. S.; Katchamart, W.; Akarawatcharangura Goo, P.; Traboco, L.; Chen, Y. -M.; Lilleker, J. B.; Nune, A.; Pauling, J. D.; Agarwal, V.; Dzifa, D.; Toro Gutierrez, C. E.; Caballero-Uribe, C. V.; Chinoy, H.; Zimba, O.; Fonseca, J. E.; Pereira Silva, J. A.; Rojas Zuleta, W. G.; Shaharir, S. S.; Landon-Cardinal, O.; Hudson, M.; Srivastav, N.; Needham, M.; Limaye, V.; Langguth, D.; Nagy-Vincze, M.; Meyer, A.; Campagne, J.; Maurier, F.; Giannini, M.; Hoff, L. S.; Hmamouchi, I.; Gheita, T. A.; Aharonov, O.; Gromova, M. A.; Tomaras, S.; Knitza, J.; Kaneko, Y.; Kimura, N.; Sato, S.; Nakashima, R.; Yoshida, A.; Kuwana, M.; Gonzalez, R. A.; Gil-Vila, A.; Prieto-Gonzalez, S.; Loarce-Martos, J.; Garcia-De La Torre, I.; Serrano, J. R.; Tehozol, E. A. Z.; Wibowo, S. A. K.; Traboco, L. S.; Milchert, M.; Venerito, V.; Danielli, M. G.; De Angelis, R.; Orsolini, G.; Sainaghi, P. P.; Franceschini, F.; Quartuccio, L.; Sebastiani, M.; Fusaro, E.; Sebastiani, G. D.; Bocci, E. B.; Parisi, S.; Govoni, M.; Fabiola, A.; Sambataro, G.; Del Papa, N.; Cavagna, L.; Wincup, C.; Pauling, J. D.; Chatterjee, T.; Makol, A.; Kim, M.; Cansu, D. U.; Kardes, S.; Chandwar, K.; Pandey, A. K. R.; Shukla, A.; Bommakanti, K. T.; Asranna, A.; Shenoy, P.; Mathew, A. J.; Chowdhury, A. C.; Goswami, R. P.; Phatak, S.; Ajmani, S.; Patro, P. S.; Kavadichanda, C. G.; Gupta, V.; M. M., M; Sharma, A.; Pilania, R. K.; Pandya, S. C.; Jain, A.; Ranjan, R.; Singh, Y. P.; Barman, B.; Agarwal, V.; Gupta, L.; Parodis, I.

doi:10.1007/s00296-024-05682-6

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.

Breakthrough SARS-CoV-2 infection in fully vaccinated patients with systemic lupus erythematosus: results from the COVID-19 Vaccination in Autoimmune Disease (COVAD) study / Palazzo, L.; Lindblom, J.; Kihlgren Olsson, E.; Nikiphorou, E.; Wincup, C.; Saha, S.; Shaharir, S. S.; Katchamart, W.; Akarawatcharangura Goo, P.; Traboco, L.; Chen, Y. -M.; Lilleker, J. B.; Nune, A.; Pauling, J. D.; Agarwal, V.; Dzifa, D.; Toro Gutierrez, C. E.; Caballero-Uribe, C. V.; Chinoy, H.; Zimba, O.; Fonseca, J. E.; Pereira Silva, J. A.; Rojas Zuleta, W. G.; Shaharir, S. S.; Landon-Cardinal, O.; Hudson, M.; Srivastav, N.; Needham, M.; Limaye, V.; Langguth, D.; Nagy-Vincze, M.; Meyer, A.; Campagne, J.; Maurier, F.; Giannini, M.; Hoff, L. S.; Hmamouchi, I.; Gheita, T. A.; Aharonov, O.; Gromova, M. A.; Tomaras, S.; Knitza, J.; Kaneko, Y.; Kimura, N.; Sato, S.; Nakashima, R.; Yoshida, A.; Kuwana, M.; Gonzalez, R. A.; Gil-Vila, A.; Prieto-Gonzalez, S.; Loarce-Martos, J.; Garcia-De La Torre, I.; Serrano, J. R.; Tehozol, E. A. Z.; Wibowo, S. A. K.; Traboco, L. S.; Milchert, M.; Venerito, V.; Danielli, M. G.; De Angelis, R.; Orsolini, G.; Sainaghi, P. P.; Franceschini, F.; Quartuccio, L.; Sebastiani, M.; Fusaro, E.; Sebastiani, G. D.; Bocci, E. B.; Parisi, S.; Govoni, M.; Fabiola, A.; Sambataro, G.; Del Papa, N.; Cavagna, L.; Wincup, C.; Pauling, J. D.; Chatterjee, T.; Makol, A.; Kim, M.; Cansu, D. U.; Kardes, S.; Chandwar, K.; Pandey, A. K. R.; Shukla, A.; Bommakanti, K. T.; Asranna, A.; Shenoy, P.; Mathew, A. J.; Chowdhury, A. C.; Goswami, R. P.; Phatak, S.; Ajmani, S.; Patro, P. S.; Kavadichanda, C. G.; Gupta, V.; M, M. M.; Sharma, A.; Pilania, R. K.; Pandya, S. C.; Jain, A.; Ranjan, R.; Singh, Y. P.; Barman, B.; Agarwal, V.; Gupta, L.; Parodis, I.. - In: RHEUMATOLOGY INTERNATIONAL. - ISSN 1437-160X. - 44:10(2024), pp. 1923-1933. [10.1007/s00296-024-05682-6]