Factors Associated with COVID-19 Breakthrough Infection Among Vaccinated Patients with Rheumatic Diseases: A Cohort Study
Patel et al.,
Factors Associated with COVID-19 Breakthrough Infection Among Vaccinated Patients with Rheumatic Diseases: A..,
Seminars in Arthritis and Rheumatism, doi:10.1016/j.semarthrit.2022.152108
Retrospective 11,468 vaccinated rheumatic disease patients, showing lower risk of COVID-19 cases with HCQ/CQ (antimalarial) treatment compared with all other treatments, statistically significant for 6 treatments.
This study is excluded in meta
analysis:
authors only provide multiple results comparing with specific other treatments.
risk of case, 41.2% lower, HR 0.59, p = 0.02, adjusted per study, inverted to make HR<1 favor treatment, HCQ/CQ vs. other csDMARD, multivariable, Cox proportional hazards.
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risk of case, 21.3% lower, HR 0.79, p = 0.34, adjusted per study, inverted to make HR<1 favor treatment, HCQ/CQ vs. methotrexate, multivariable, Cox proportional hazards.
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risk of case, 54.8% lower, HR 0.45, p = 0.003, adjusted per study, inverted to make HR<1 favor treatment, HCQ/CQ vs. TNF inhibitor, multivariable, Cox proportional hazards.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Patel et al., 26 Oct 2022, retrospective, USA, peer-reviewed, mean age 60.0, 12 authors.
Contact:
zswallace@mgh.harvard.edu.
Abstract: Journal Pre-proof
Factors Associated with COVID-19 Breakthrough Infection Among
Vaccinated Patients with Rheumatic Diseases: A Cohort Study
Naomi J. Patel , Xiaosong Wang , Xiaoqing Fu , Yumeko Kawano ,
Claire Cook , Kathleen M.M. Vanni , Grace Qian , Emily Banasiak ,
Emily Kowalski , Yuqing Zhang , Jeffrey A. Sparks ,
Zachary S. Wallace
PII:
DOI:
Reference:
S0049-0172(22)00159-7
https://doi.org/10.1016/j.semarthrit.2022.152108
YSARH 152108
To appear in:
Seminars in Arthritis & Rheumatism
Please cite this article as: Naomi J. Patel , Xiaosong Wang , Xiaoqing Fu , Yumeko Kawano ,
Claire Cook ,
Kathleen M.M. Vanni ,
Grace Qian ,
Emily Banasiak ,
Emily Kowalski ,
Yuqing Zhang , Jeffrey A. Sparks , Zachary S. Wallace , Factors Associated with COVID-19 Breakthrough Infection Among Vaccinated Patients with Rheumatic Diseases: A Cohort Study, Seminars in
Arthritis & Rheumatism (2022), doi: https://doi.org/10.1016/j.semarthrit.2022.152108
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Factors Associated with COVID-19 Breakthrough Infection Among Vaccinated Patients with
Rheumatic Diseases: A Cohort Study
Naomi J. Patel1,4; Xiaosong Wang2, Xiaoqing Fu1; Yumeko Kawano2,4; Claire Cook1,3; Kathleen
M.M. Vanni2; Grace Qian2; Emily Banasiak2; Emily Kowalski2; Yuqing Zhang1,3,4; Jeffrey A.
Sparks2,4*; Zachary S. Wallace1,3,4,*,# zswallace@mgh.harvard.edu
1
Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital,
Rheumatology Associates, 55 Fruit Street, Boston, MA, 02114, USA
2
Division of Rheumatology, Inflammation, and Immunity, Brigham and Women’s Hospital, 60
Fenwood Road, Boston, MA, 02115, USA
3
Clinical Epidemiology Program, Mongan Institute, Department of Medicine, Massachusetts
General Hospital, The Mongan Institute, 100 Cambridge Street, Suite 1600, Boston, MA, 02114,
USA
4
Harvard Medical School, Boston, MA
*
Corresponding author: Zachary S. Wallace, Clinical Epidemiology Program, Division of
Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 100 Cambridge
Street, 16th Floor, Boston, MA, 02114
*
These authors contributed equally to this work (co-last authors).
Abstract
Objective: Rheumatic disease patients on certain immunomodulators are at increased risk of
impaired humoral response to SARS-CoV-2 vaccines. We aimed to identify factors associated
with breakthrough infection among patients with rheumatic diseases.
Methods: We identified patients with rheumatic diseases being treated with immunomodulators
in a large healthcare system who received at least two doses of either the mRNA-1273
(Moderna) or BNT162b2 (Pfizer-BioNTech) vaccines or one dose of the Johnson & JohnsonJanssen (J&J) vaccine. We followed patients until SARS-CoV-2 infection, death, or December
15, 2021, when the Omicron variant became dominant in our region. We estimated the
association of baseline characteristics with the risk of breakthrough..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
FLCCC and
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provide treatment protocols.
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