Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study

COVAD Study Group; Leonardo Santos Hoff; Naveen Ravichandran; Parikshit Sen; Jessica Day; Mrudula Joshi; Arvind Nune; Elena Nikiphorou; Sreoshy Saha; Ai Lyn Tan; Samuel Katsuyuki Shinjo; Nelly Ziade; Tsvetelina Velikova; Marcin Milchert; Kshitij Jagtap; Ioannis Parodis; Abraham Edgar Gracia-Ramos; Lorenzo Cavagna; Masataka Kuwana; Johannes Knitza; Yi Ming Chen; Ashima Makol; Vishwesh Agarwal; Aarat Patel; John D Pauling; Chris Wincup; Bhupen Barman; Erick Adrian Zamora Tehozol; Jorge Rojas Serrano; Ignacio García-De La Torre; Iris J Colunga-Pedraza; Javier Merayo-Chalico; Okwara Celestine Chibuzo; Wanruchada Katchamart; Phonpen Akarawatcharangura Goo; Russka Shumnalieva; Lina El Kibbi; Hussein Halabi; Binit Vaidya; Syahrul Sazliyana Shaharir; A T M Tanveer Hasan; Dzifa Dey; Carlos Enrique Toro Gutiérrez; Carlo V Caballero-Uribe; James B Lilleker; Babur Salim; Tamer Gheita; Tulika Chatterjee; Oliver Distler; Miguel A Saavedra; Hector Chinoy; Vikas Agarwal; Rohit Aggarwal; Latika Gupta

doi:10.1093/rheumatology/keae128

Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study

COVAD Study Group
, Leonardo Santos Hoff
, Naveen Ravichandran
, Parikshit Sen
, Jessica Day
, Mrudula Joshi
, Arvind Nune
, Elena Nikiphorou
, Sreoshy Saha
, Ai Lyn Tan
, Samuel Katsuyuki Shinjo
, Nelly Ziade
, Tsvetelina Velikova
, Marcin Milchert
, Kshitij Jagtap
, Ioannis Parodis
, Abraham Edgar Gracia-Ramos
, Lorenzo Cavagna
, Masataka Kuwana
, Johannes Knitza

Yi Ming Chen, Ashima Makol, Vishwesh Agarwal, Aarat Patel, John D Pauling, Chris Wincup, Bhupen Barman, Erick Adrian Zamora Tehozol, Jorge Rojas Serrano, Ignacio García-De La Torre, Iris J Colunga-Pedraza, Javier Merayo-Chalico, Okwara Celestine Chibuzo, Wanruchada Katchamart, Phonpen Akarawatcharangura Goo, Russka Shumnalieva, Lina El Kibbi, Hussein Halabi, Binit Vaidya, Syahrul Sazliyana Shaharir, A T M Tanveer Hasan, Dzifa Dey, Carlos Enrique Toro Gutiérrez, Carlo V Caballero-Uribe, James B Lilleker, Babur Salim, Tamer Gheita, Tulika Chatterjee, Oliver Distler, Miguel A Saavedra, Hector Chinoy, Vikas Agarwal, Rohit Aggarwal, Latika Gupta^*

^*Corresponding author for this work

Inflammation and Ageing

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.

METHODS: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI ,and hospitalizations among patients with IIMs.

RESULTS: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3%). The median age was 44 years [interquartile range (IQR) 21], 77.4% were female, and 182 BIs (12.9%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95% CI = 1.24-2.64, and HR = 3.79, 95% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0% vs AIRDs = 1.8%, nrAIDs = 2.2% and HCs = 0.9%), intensive care unit admission (IIMs = 2.2% vs AIRDs = 0.6%, nrAIDs and HCs = 0%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1% vs AIRDs = 25.8%, nrAIDs = 14.6% and HCs = 12.8%) and had more hospitalization (IIMs = 7.7% vs AIRDs = 4.6%, nrAIDs = 1.1% and HCs = 1.5%).

CONCLUSION: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.

Original language	English
Pages (from-to)	597-606
Number of pages	10
Journal	Rheumatology (Oxford, England)
Volume	64
Issue number	2
Early online date	2 Mar 2024
DOIs	https://doi.org/10.1093/rheumatology/keae128
Publication status	Published - Feb 2025

Bibliographical note

Keywords

Humans
Female
Male
COVID-19/epidemiology
Myositis/epidemiology
Adult
Risk Factors
Middle Aged
SARS-CoV-2
COVID-19 Vaccines
Hospitalization/statistics & numerical data
Prevalence
Severity of Illness Index

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/rheumatology/keae128

Cite this

COVAD Study Group, Hoff, L. S., Ravichandran, N., Sen, P., Day, J., Joshi, M., Nune, A., Nikiphorou, E., Saha, S., Tan, A. L., Shinjo, S. K., Ziade, N., Velikova, T., Milchert, M., Jagtap, K., Parodis, I., Gracia-Ramos, A. E., Cavagna, L., Kuwana, M., ... Gupta, L. (2025). Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study. Rheumatology (Oxford, England), 64(2), 597-606. https://doi.org/10.1093/rheumatology/keae128

@article{f78eacf5cf554a298e2700e31e4e038a,

title = "Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study",

abstract = "OBJECTIVES: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.METHODS: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI ,and hospitalizations among patients with IIMs.RESULTS: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3\%). The median age was 44 years [interquartile range (IQR) 21], 77.4\% were female, and 182 BIs (12.9\%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95\% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95\% CI = 1.24-2.64, and HR = 3.79, 95\% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95\% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95\% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0\% vs AIRDs = 1.8\%, nrAIDs = 2.2\% and HCs = 0.9\%), intensive care unit admission (IIMs = 2.2\% vs AIRDs = 0.6\%, nrAIDs and HCs = 0\%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1\% vs AIRDs = 25.8\%, nrAIDs = 14.6\% and HCs = 12.8\%) and had more hospitalization (IIMs = 7.7\% vs AIRDs = 4.6\%, nrAIDs = 1.1\% and HCs = 1.5\%).CONCLUSION: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.",

keywords = "Humans, Female, Male, COVID-19/epidemiology, Myositis/epidemiology, Adult, Risk Factors, Middle Aged, SARS-CoV-2, COVID-19 Vaccines, Hospitalization/statistics \& numerical data, Prevalence, Severity of Illness Index",

author = "\{COVAD Study Group\} and Hoff, \{Leonardo Santos\} and Naveen Ravichandran and Parikshit Sen and Jessica Day and Mrudula Joshi and Arvind Nune and Elena Nikiphorou and Sreoshy Saha and Tan, \{Ai Lyn\} and Shinjo, \{Samuel Katsuyuki\} and Nelly Ziade and Tsvetelina Velikova and Marcin Milchert and Kshitij Jagtap and Ioannis Parodis and Gracia-Ramos, \{Abraham Edgar\} and Lorenzo Cavagna and Masataka Kuwana and Johannes Knitza and Chen, \{Yi Ming\} and Ashima Makol and Vishwesh Agarwal and Aarat Patel and Pauling, \{John D\} and Chris Wincup and Bhupen Barman and Tehozol, \{Erick Adrian Zamora\} and Serrano, \{Jorge Rojas\} and Torre, \{Ignacio Garc{\'i}a-De La\} and Colunga-Pedraza, \{Iris J\} and Javier Merayo-Chalico and Chibuzo, \{Okwara Celestine\} and Wanruchada Katchamart and Goo, \{Phonpen Akarawatcharangura\} and Russka Shumnalieva and \{El Kibbi\}, Lina and Hussein Halabi and Binit Vaidya and Shaharir, \{Syahrul Sazliyana\} and Hasan, \{A T M Tanveer\} and Dzifa Dey and Guti{\'e}rrez, \{Carlos Enrique Toro\} and Caballero-Uribe, \{Carlo V\} and Lilleker, \{James B\} and Babur Salim and Tamer Gheita and Tulika Chatterjee and Oliver Distler and Saavedra, \{Miguel A\} and Hector Chinoy and Vikas Agarwal and Rohit Aggarwal and Latika Gupta",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: [email protected].",

year = "2025",

month = feb,

doi = "10.1093/rheumatology/keae128",

language = "English",

volume = "64",

pages = "597--606",

journal = "Rheumatology (Oxford, England)",

issn = "1462-0324",

publisher = "Oxford University Press",

number = "2",

}

COVAD Study Group, Hoff, LS, Ravichandran, N, Sen, P, Day, J, Joshi, M, Nune, A, Nikiphorou, E, Saha, S, Tan, AL, Shinjo, SK, Ziade, N, Velikova, T, Milchert, M, Jagtap, K, Parodis, I, Gracia-Ramos, AE, Cavagna, L, Kuwana, M, Knitza, J, Chen, YM, Makol, A, Agarwal, V, Patel, A, Pauling, JD, Wincup, C, Barman, B, Tehozol, EAZ, Serrano, JR, Torre, IG-DL, Colunga-Pedraza, IJ, Merayo-Chalico, J, Chibuzo, OC, Katchamart, W, Goo, PA, Shumnalieva, R, El Kibbi, L, Halabi, H, Vaidya, B, Shaharir, SS, Hasan, ATMT, Dey, D, Gutiérrez, CET, Caballero-Uribe, CV, Lilleker, JB, Salim, B, Gheita, T, Chatterjee, T, Distler, O, Saavedra, MA, Chinoy, H, Agarwal, V, Aggarwal, R & Gupta, L 2025, 'Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study', Rheumatology (Oxford, England), vol. 64, no. 2, pp. 597-606. https://doi.org/10.1093/rheumatology/keae128

TY - JOUR

T1 - Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies

T2 - results from the COVAD study

AU - COVAD Study Group

AU - Hoff, Leonardo Santos

AU - Ravichandran, Naveen

AU - Sen, Parikshit

AU - Day, Jessica

AU - Joshi, Mrudula

AU - Nune, Arvind

AU - Nikiphorou, Elena

AU - Saha, Sreoshy

AU - Tan, Ai Lyn

AU - Shinjo, Samuel Katsuyuki

AU - Ziade, Nelly

AU - Velikova, Tsvetelina

AU - Milchert, Marcin

AU - Jagtap, Kshitij

AU - Parodis, Ioannis

AU - Gracia-Ramos, Abraham Edgar

AU - Cavagna, Lorenzo

AU - Kuwana, Masataka

AU - Knitza, Johannes

AU - Chen, Yi Ming

AU - Makol, Ashima

AU - Agarwal, Vishwesh

AU - Patel, Aarat

AU - Pauling, John D

AU - Wincup, Chris

AU - Barman, Bhupen

AU - Tehozol, Erick Adrian Zamora

AU - Serrano, Jorge Rojas

AU - Torre, Ignacio García-De La

AU - Colunga-Pedraza, Iris J

AU - Merayo-Chalico, Javier

AU - Chibuzo, Okwara Celestine

AU - Katchamart, Wanruchada

AU - Goo, Phonpen Akarawatcharangura

AU - Shumnalieva, Russka

AU - El Kibbi, Lina

AU - Halabi, Hussein

AU - Vaidya, Binit

AU - Shaharir, Syahrul Sazliyana

AU - Hasan, A T M Tanveer

AU - Dey, Dzifa

AU - Gutiérrez, Carlos Enrique Toro

AU - Caballero-Uribe, Carlo V

AU - Lilleker, James B

AU - Salim, Babur

AU - Gheita, Tamer

AU - Chatterjee, Tulika

AU - Distler, Oliver

AU - Saavedra, Miguel A

AU - Chinoy, Hector

AU - Agarwal, Vikas

AU - Aggarwal, Rohit

AU - Gupta, Latika

PY - 2025/2

Y1 - 2025/2

N2 - OBJECTIVES: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.METHODS: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI ,and hospitalizations among patients with IIMs.RESULTS: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3%). The median age was 44 years [interquartile range (IQR) 21], 77.4% were female, and 182 BIs (12.9%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95% CI = 1.24-2.64, and HR = 3.79, 95% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0% vs AIRDs = 1.8%, nrAIDs = 2.2% and HCs = 0.9%), intensive care unit admission (IIMs = 2.2% vs AIRDs = 0.6%, nrAIDs and HCs = 0%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1% vs AIRDs = 25.8%, nrAIDs = 14.6% and HCs = 12.8%) and had more hospitalization (IIMs = 7.7% vs AIRDs = 4.6%, nrAIDs = 1.1% and HCs = 1.5%).CONCLUSION: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.

AB - OBJECTIVES: The objective of this study was to explore the prevalence, characteristics and risk factors of COVID-19 breakthrough infections (BIs) in idiopathic inflammatory myopathies (IIMs) using data from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study.METHODS: A validated patient self-reporting e-survey was circulated by the COVAD study group to collect data on COVID-19 infection and vaccination in 2022. BIs were defined as COVID-19 occurring ≥14 days after two vaccine doses. We compared BI characteristics and severity among patients with IIMs, patients with other autoimmune rheumatic and non-rheumatic diseases (AIRD, nrAID), and healthy controls (HCs). Multivariable Cox regression models were used to assess the risk factors for BI, severe BI ,and hospitalizations among patients with IIMs.RESULTS: Among the 9449 included responses, BIs occurred in 1447 respondents (15.3%). The median age was 44 years [interquartile range (IQR) 21], 77.4% were female, and 182 BIs (12.9%) occurred among the 1406 patients with IIMs. Multivariable Cox regression among the data for patients with IIMs showed increasing age to be a protective factor for BIs [hazard ratio (HR) = 0.98, 95% CI = 0.97-0.99], and HCQ and SSZ use were risk factors (HR = 1.81, 95% CI = 1.24-2.64, and HR = 3.79, 95% CI = 1.69-8.42, respectively). Glucocorticoid use was a risk factor for a severe BI (HR = 3.61, 95% CI = 1.09-11.8). Non-white ethnicity (HR = 2.61, 95% CI = 1.03-6.59) was a risk factor for hospitalization. Compared with other groups, patients with IIMs required more supplemental oxygen therapy (IIMs = 6.0% vs AIRDs = 1.8%, nrAIDs = 2.2% and HCs = 0.9%), intensive care unit admission (IIMs = 2.2% vs AIRDs = 0.6%, nrAIDs and HCs = 0%), advanced treatment with antiviral or monoclonal antibodies (IIMs = 34.1% vs AIRDs = 25.8%, nrAIDs = 14.6% and HCs = 12.8%) and had more hospitalization (IIMs = 7.7% vs AIRDs = 4.6%, nrAIDs = 1.1% and HCs = 1.5%).CONCLUSION: Patients with IIMs are susceptible to severe COVID-19 BIs. Age and immunosuppressive treatments were related to the risk of BIs.

KW - Humans

KW - Female

KW - Male

KW - COVID-19/epidemiology

KW - Myositis/epidemiology

KW - Adult

KW - Risk Factors

KW - Middle Aged

KW - SARS-CoV-2

KW - COVID-19 Vaccines

KW - Hospitalization/statistics & numerical data

KW - Prevalence

KW - Severity of Illness Index

U2 - 10.1093/rheumatology/keae128

DO - 10.1093/rheumatology/keae128

M3 - Article

C2 - 38430474

SN - 1462-0324

VL - 64

SP - 597

EP - 606

JO - Rheumatology (Oxford, England)

JF - Rheumatology (Oxford, England)

IS - 2

ER -

Characteristics of and risk factors for COVID-19 breakthrough infections in idiopathic inflammatory myopathies: results from the COVAD study

Abstract

Bibliographical note

Keywords

UN SDGs

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