Breakthrough infections with the SARS-CoV-2 omicron (B.1.1.529) variant in patients with immune-mediated inflammatory diseases

T2B Immunity Against SARS Co, Eileen W. Stalman, Luuk Wieske, Koos P. J. van Dam, Laura Y. Kummer, Zoe L. E. van Kempen, Joep Killestein, Adriaan G. Volkers, Sander W. Tas, Laura Boekel, Gertjan J. Wolbink, Anneke J. Van der Kooi, Joost Raaphorst, Mark Lowenberg, R. Bart Takkenberg, Geert R. A. M. D'Haens, Phyllis Spuls, Marcel W. Bekkenk, Annelie H. Musters, Nicoline F. PostAngela L. Bosma, Marc L. Hilhorst, Yosta Vegting, Frederique J. Bemelman, Alexandre E. Voskuyl, Bo Broens, Agner Parra Sanchez, Cecile A. C. M. van Els, Jelle De Wit, Abraham Rutgers, Karina de Leeuw, Barbara Horvath, Jan J. G. M. Verschuuren, Annabel M. Ruiter, Lotte van Ouwerkerk, Diane van der Woude, C. F. Allaart, Onno Y. K. Teng, Pieter van Paassen, Matthias H. Busch, Papay B. P. Jallah, Esther Brusse, Pieter A. van Doorn, Adaja Elisabeth Baars, Dirk Jan Hijnen, Corine R. G. Schreurs, W. Ludo Van der Pol, H. Stephan Goedee, Maurice Steenhuis, Sofie Keijzer, Theo Rispens

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1 Citaat (Scopus)

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Objectives To compare the cumulative incidence and disease severity of reported SARS-CoV-2 omicron breakthrough infections between patients with immune-mediated inflammatory diseases (IMID) on immunosuppressants and controls, and to investigate determinants for breakthrough infections. Methods Data were used from an ongoing national prospective multicentre cohort study on SARS-CoV-2 vaccination responses in patients with IMID in the Netherlands (Target-to-B! (T2B!) study). Patients wih IMID on immunosuppressants and controls (patients with IMID not on immunosuppressants and healthy controls) who completed primary immunisation were included. The observation period was between 1 January 2022 and 1 April 2022, during which the SARS-CoV-2 omicron (BA.1 and BA.2 subvariant) was dominant. A SARS-CoV-2 breakthrough infection was defined as a reported positive PCR and/or antigen test at least 14 days after primary immunisation. A multivariate logistic regression model was used to investigate determinants. Results 1593 patients with IMID on immunosuppressants and 579 controls were included. The cumulative incidence of breakthrough infections was 472/1593 (29.6%; 95% CI 27% to 32%) in patients with IMID on immunosuppressants and 181/579 (31.3%; 95% CI 28% to 35%) in controls (p=0.42). Three (0.5%) participants had severe disease. Seroconversion after primary immunisation (relative risk, RR 0.71; 95% CI 0.52 to 0.96), additional vaccinations (RR 0.61; 95% CI 0.49 to 0.76) and a prior SARS-CoV-2 infection (RR 0.60; 95% CI 0.48 to 0.75) were associated with decreased risk of breakthrough infection. Conclusions The cumulative incidence of reported SARS-CoV-2 omicron breakthrough infections was high, but similar between patients with IMID on immunosuppressants and controls, and disease severity was mostly mild. Additional vaccinations and prior SARS-CoV-2 infections may reduce the incidence of breakthrough infections.

Originele taal-2English
Aantal pagina's10
TijdschriftAnnals of the Rheumatic Diseases
DOI's
StatusE-pub ahead of print - 5-sep.-2022

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