Factors associated with COVID-19 breakthrough infection among vaccinated patients with rheumatic diseases: A cohort study
Authors' conclusion
Among patients with rheumatic diseases, multiple immunomodulators were associated with increased risk of breakthrough infection.
Study context
- Population
- Patients with rheumatic diseases on immunomodulators in a large healthcare system, vaccinated with ≥2 doses of mRNA-1273 or BNT162b2 or one dose of J&J vaccine; followed until December 15, 2021 (Omicron dominance)75% female, mean age 60 years
- Participants
- 11,468 patients
- Exposure
- Immunomodulators vs antimalarial monotherapy; mRNA-1273 vs BNT162b2
- Outcome
- SARS-CoV-2 breakthrough infection (follow-up until infection, death, or December 15, 2021, when Omicron became dominant)
Methodological detailsmultivariable Cox regression
- Multivariable Cox regression
Main finding
As reported in the abstract
Breakthrough infection by immunomodulator
Each group vs antimalarial monotherapyAdjusted hazard ratio (95% CI)
Anti-CD20 monoclonal antibodies
5.20(2.85–9.48)
CTLA-4 Ig
3.52(1.90–6.51)
Mycophenolate
2.31(1.25–4.27)
IL-6 inhibitors
2.15(1.09–4.24)
JAK inhibitors
2.02(1.01–4.06)
TNF inhibitors
1.70(1.09–2.66)
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| Breakthrough infection by vaccinemRNA-1273vs BNT162b2 | 0.66 (0.50–0.86) | |
| 0.512Adjusted hazard ratio (log scale) |
Breakthrough infection by sex, BMI, smoking status, race, ethnicity
- No association of sex, BMI, smoking status, race, or ethnicity with risk of breakthrough infection
Original publication
Factors associated with COVID-19 breakthrough infection among vaccinated patients with rheumatic diseases: A cohort study. Semin Arthritis Rheum. Published 26 October 2022. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →