PMID- 37068915
OWN - NLM
STAT- MEDLINE
DCOM- 20230419
LR  - 20230421
IS  - 2056-5933 (Electronic)
IS  - 2056-5933 (Linking)
VI  - 9
IP  - 2
DP  - 2023 Apr
TI  - Characteristics and outcomes of SARS-CoV-2 breakthrough infections among 
      double-vaccinated and triple-vaccinated patients with inflammatory rheumatic 
      diseases.
LID - 10.1136/rmdopen-2023-002998 [doi]
LID - e002998
AB  - OBJECTIVE: To analyse the clinical profile of SARS-CoV-2 breakthrough infections 
      in at least double-vaccinated patients with inflammatory rheumatic diseases 
      (IRDs). METHODS: Data 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. RESULTS: In 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). 
      CONCLUSIONS: Our 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. TRIAL REGISTRATION NUMBER: EuDRACT 
      2020-001958-21.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Hasseli, Rebecca
AU  - Hasseli R
AUID- ORCID: 0000-0002-2982-8253
AD  - Department of Internal Medicine D, Section of Rheumatology and Clinical 
      Immunology, University Hospital Munster, Munster, Germany hasseli@rheumathek.de.
AD  - Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus 
      Liebig University Giessen, Giessen, Germany.
FAU - Richter, Jutta G
AU  - Richter JG
AD  - Clinic for Rheumatology, University Hospital Duesseldorf, Medical Faculty of 
      Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
AD  - Hiller Research Center, University Hospital Duesseldorf, Medical Faculty of 
      Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
FAU - Hoyer, Bimba Franziska
AU  - Hoyer BF
AUID- ORCID: 0000-0002-5252-1719
AD  - Clinic for Internal Medicine I, Rheumatology and Clinical Immunology, University 
      Medical Center Schleswig-Holstein Campus, Kiel, Germany.
FAU - Lorenz, Hanns-Martin
AU  - Lorenz HM
AD  - Division of Rheumatology, Department of Medicine V, University Hospital 
      Heidelberg, Heidelberg, Germany.
FAU - Pfeil, Alexander
AU  - Pfeil A
AUID- ORCID: 0000-0002-2709-6685
AD  - Department of Internal Medicine III, University Hospital Jena, Jena, Germany.
FAU - Regierer, Anne Constanze
AU  - Regierer AC
AUID- ORCID: 0000-0003-2456-4049
AD  - Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.
FAU - Schmeiser, Tim
AU  - Schmeiser T
AUID- ORCID: 0000-0001-7342-0020
AD  - Rheumatology, Private Practice "Rheumatologie im Veedel" Cologne, Cologne, 
      Germany.
FAU - Strangfeld, Anja
AU  - Strangfeld A
AUID- ORCID: 0000-0002-6233-022X
AD  - Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.
AD  - Department of Rheumatology and Clinical Immunology, Charite Universitatsmedizin, 
      Berlin, Germany.
FAU - Voll, Reinhard E
AU  - Voll RE
AD  - Department of Rheumatology and Clinical Immunology, Medical Center - University 
      of Freiburg, Faculty of Medicine, Freiburg, Germany.
AD  - Centre of Chronic Immunodeficiency, Medical Center - University of Freiburg, 
      Faculty of Medicine, Freiburg, Germany.
FAU - Krause, Andreas
AU  - Krause A
AD  - Department of Rheumatology, Clinical Immunology and Osteology, Immanuel Hospital, 
      Berlin, Germany.
FAU - Reckert, Sabine
AU  - Reckert S
AD  - Rheumatology, Private Practice, Potsdam, Germany.
FAU - Grassler, Anett
AU  - Grassler A
AD  - Rheumatology, Private Practice, Pirna, Germany.
FAU - Saar, Petra
AU  - Saar P
AD  - Rheumatology, Private Practice Endokrinologikum, Frankfurt, Germany.
FAU - Kapelle, Andreas
AU  - Kapelle A
AD  - Rheumatology, Private Practice, Hoyerswerda, Germany.
FAU - Backhaus, Marina
AU  - Backhaus M
AD  - Department of Internal Medicine, Rheumatology and Clinical Immunology, 
      Park-Klinik Weissensee, Academic Hospital of the Charite Berlin, Berlin, Germany.
FAU - Blank, Norbert
AU  - Blank N
AD  - Division of Rheumatology, Department of Medicine V, University Hospital 
      Heidelberg, Heidelberg, Germany.
FAU - Henes, Joerg
AU  - Henes J
AD  - Centre for Interdisciplinary Clinical Immunology, Rheumatology and 
      Autoinflammatory Diseases (INDIRA) and Department of Internal Medicine II 
      (Oncology, Haematology, Rheumatology and Clinical Immunology), University 
      Hospital Tuebingen, Tuebingen, Germany.
FAU - Osiek, Silke
AU  - Osiek S
AD  - Rheumatology, Private Practice Dialysezentrum, Schweinfurt, Germany.
FAU - Knothe, Anna
AU  - Knothe A
AD  - Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus 
      Liebig University Giessen, Giessen, Germany.
FAU - Hoese, Guido
AU  - Hoese G
AD  - Rheumatology, Private Practice, Stadthagen, Germany.
FAU - Brandt-Jurgens, Jan
AU  - Brandt-Jurgens J
AD  - Rheumatology, Private Practice, Berlin, Germany.
FAU - Maltzahn, Anja
AU  - Maltzahn A
AD  - Rheumatology, Private Practice, Gottingen, Germany.
FAU - Specker, Christof
AU  - Specker C
AUID- ORCID: 0000-0003-2504-3229
AD  - Department of Rheumatology and Clinical Immunology, KEM Kliniken Essen-Mitte, 
      Essen, Germany.
FAU - Muller-Ladner, Ulf
AU  - Muller-Ladner U
AD  - Department of Rheumatology and Clinical Immunology, Campus Kerckhoff, Justus 
      Liebig University Giessen, Giessen, Germany.
FAU - Schulze-Koops, Hendrik
AU  - Schulze-Koops H
AUID- ORCID: 0000-0002-1681-491X
AD  - Division of Rheumatology and Clinical Immunology, Department of Internal Medicine 
      IV, Ludwig-Maximilians-University, Munich, Germany.
CN  - COVID-19 task force of the German Society of Rheumatology collaborators
CN  - COVID19-Rheuma.de collaborators
LA  - eng
SI  - EudraCT/2020-001958-21
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - RMD Open
JT  - RMD open
JID - 101662038
RN  - 0 (COVID-19 Vaccines)
RN  - COVID-19 breakthrough infections
SB  - IM
MH  - Humans
MH  - COVID-19 Vaccines/therapeutic use
MH  - *COVID-19/epidemiology/prevention & control
MH  - SARS-CoV-2
MH  - Breakthrough Infections
MH  - Cross-Sectional Studies
MH  - *Rheumatic Diseases/complications/epidemiology
PMC - PMC10111193
OTO - NOTNLM
OT  - COVID-19
OT  - antirheumatic agents
OT  - inflammation
OT  - vaccination
COIS- Competing interests: None declared.
FIR - Albach, Fredrik
IR  - Albach F
FIR - Alberding, Annette
IR  - Alberding A
FIR - Alexander, Tobias
IR  - Alexander T
FIR - Alten, Rieke
IR  - Alten R
FIR - Aman, Susanne
IR  - Aman S
FIR - Amberger, Christopher
IR  - Amberger C
FIR - Amberger, Michaela
IR  - Amberger M
FIR - Andermann, Bianka
IR  - Andermann B
FIR - Anders, Nils
IR  - Anders N
FIR - Andreica, Ioana
IR  - Andreica I
FIR - Andresen, Jan
IR  - Andresen J
FIR - Andriopoulos, Nikolaos
IR  - Andriopoulos N
FIR - Arauj, Elizabeth
IR  - Arauj E
FIR - Aries, Peer
IR  - Aries P
FIR - Aringer, Martin
IR  - Aringer M
FIR - Arndt, Uta
IR  - Arndt U
FIR - Avemarg, Sarah
IR  - Avemarg S
FIR - Baerwald, Christoph
IR  - Baerwald C
FIR - Barlin, Erich
IR  - Barlin E
FIR - Bartholoma, Nora
IR  - Bartholoma N
FIR - Bastian, Hans
IR  - Bastian H
FIR - Bauerle, Michael
IR  - Bauerle M
FIR - Bauhammer, Jutta
IR  - Bauhammer J
FIR - Baumann, Christine
IR  - Baumann C
FIR - Becker, Klaus
IR  - Becker K
FIR - Becker, Heidemarie
IR  - Becker H
FIR - Bellm, Michaela
IR  - Bellm M
FIR - Berger, Sylvia
IR  - Berger S
FIR - Berghofen, Andrea
IR  - Berghofen A
FIR - Birkner, Gerhard
IR  - Birkner G
FIR - Blendea, Daniel
IR  - Blendea D
FIR - Bloching, Hans
IR  - Bloching H
FIR - Blotz, Sebastian
IR  - Blotz S
FIR - Blum, Christian
IR  - Blum C
FIR - Boeddeker, Stephanie
IR  - Boeddeker S
FIR - Bogner, Susanne
IR  - Bogner S
FIR - Bohl-Buhler, Martin
IR  - Bohl-Buhler M
FIR - Bohnen, Lara
IR  - Bohnen L
FIR - Bosenberg, Ilka
IR  - Bosenberg I
FIR - Bottcher, Nicole
IR  - Bottcher N
FIR - Braun, Matthias
IR  - Braun M
FIR - Braun, Diana
IR  - Braun D
FIR - Braunisch, Matthias
IR  - Braunisch M
FIR - Bremer, Jan Philipp
IR  - Bremer JP
FIR - Broll, Matthias
IR  - Broll M
FIR - Bruckner, Andreas
IR  - Bruckner A
FIR - Brumberger, Veronika
IR  - Brumberger V
FIR - Brzank, Martin
IR  - Brzank M
FIR - Bullesfeld, Sahra
IR  - Bullesfeld S
FIR - Burger, Sandra
IR  - Burger S
FIR - Chehab, Gamal
IR  - Chehab G
FIR - Christenn, Michaela
IR  - Christenn M
FIR - Claussnitzer, Anne
IR  - Claussnitzer A
FIR - Groot, Kirsten de
IR  - Groot K
FIR - Decker, Elvira
IR  - Decker E
FIR - Demtroder, Frank
IR  - Demtroder F
FIR - Detert, Jacqueline
IR  - Detert J
FIR - Dorfler, Rainer
IR  - Dorfler R
FIR - Drexler, Elke
IR  - Drexler E
FIR - Dudics, Valeria
IR  - Dudics V
FIR - Edelmann, Edmund
IR  - Edelmann E
FIR - Eder, Roman
IR  - Eder R
FIR - Eisterhues, Christina
IR  - Eisterhues C
FIR - Engel, Joachim Michael
IR  - Engel JM
FIR - Erbsloh-Moller, Brigitte
IR  - Erbsloh-Moller B
FIR - Feine, Miriam
IR  - Feine M
FIR - Ferdinan, Samantha
IR  - Ferdinan S
FIR - Feuchtenberger, Martin
IR  - Feuchtenberger M
FIR - Fiehn, Christoph
IR  - Fiehn C
FIR - Finzel, Stephanie
IR  - Finzel S
FIR - Fischer-Betz, Rebecca
IR  - Fischer-Betz R
FIR - Fleck, Martin
IR  - Fleck M
FIR - Franke, Claudia
IR  - Franke C
FIR - Freudenberg, Stefanie
IR  - Freudenberg S
FIR - Frabel, Christian
IR  - Frabel C
FIR - Fuchs, Petra
IR  - Fuchs P
FIR - Gaissmaier, Regina
IR  - Gaissmaier R
FIR - Gao, Ino
IR  - Gao I
FIR - Gardt, Oliver
IR  - Gardt O
FIR - Gauler, Georg
IR  - Gauler G
FIR - Geissler, Katrin
IR  - Geissler K
FIR - Gente, Karolina
IR  - Gente K
FIR - Georgi, Joachim
IR  - Georgi J
FIR - Gilly, Jasmin
IR  - Gilly J
FIR - Gkanatsas, Yannik
IR  - Gkanatsas Y
FIR - Glaser, Cornelia
IR  - Glaser C
FIR - Schwister, Agnes Gniezinski-
IR  - Schwister AG
FIR - Gold, Rahel
IR  - Gold R
FIR - Gorl, Norman
IR  - Gorl N
FIR - Gorlitz, Ralf
IR  - Gorlitz R
FIR - Gottl, Karl-Heinz
IR  - Gottl KH
FIR - Gottle, Beate
IR  - Gottle B
FIR - Bouyer, Ricardo Grieshaber
IR  - Bouyer RG
FIR - Grothues, Gisela
IR  - Grothues G
FIR - Grunke, Mathias
IR  - Grunke M
FIR - Gunther, Janine
IR  - Gunther J
FIR - Gunther, Florian
IR  - Gunther F
FIR - Haag, Mirjam
IR  - Haag M
FIR - Haas, Linda
IR  - Haas L
FIR - Haas-Wohrle, Anna
IR  - Haas-Wohrle A
FIR - Hadjiski, Denitsa
IR  - Hadjiski D
FIR - Haibel, Hildrun
IR  - Haibel H
FIR - Hallmann-Bohm, Till
IR  - Hallmann-Bohm T
FIR - Harle, Peter
IR  - Harle P
FIR - Hartmann, Urs
IR  - Hartmann U
FIR - Hasenkamp, Charlotte
IR  - Hasenkamp C
FIR - Hauf, Maura-Maria
IR  - Hauf MM
FIR - Hauser, Matthias
IR  - Hauser M
EDAT- 2023/04/18 06:00
MHDA- 2023/04/19 06:42
PMCR- 2023/04/17
CRDT- 2023/04/17 21:03
PHST- 2023/01/11 00:00 [received]
PHST- 2023/03/22 00:00 [accepted]
PHST- 2023/04/19 06:42 [medline]
PHST- 2023/04/17 21:03 [entrez]
PHST- 2023/04/18 06:00 [pubmed]
PHST- 2023/04/17 00:00 [pmc-release]
AID - rmdopen-2023-002998 [pii]
AID - 10.1136/rmdopen-2023-002998 [doi]
PST - ppublish
SO  - RMD Open. 2023 Apr;9(2):e002998. doi: 10.1136/rmdopen-2023-002998.