AB0078 PREDICTORS OF HOSPITALIZATION DUE TO BREAKTHROUGH COVID-19 INFECTION IN PATIENTS WITH IMMUNE-MEDIATED RHEUMATIC DISEASES: DATA FROM SAFER STUDY
Authors: D. Calderaro, K. Lysie Libardi Lira Machado, E. Torres Dos Reis Neto, S. Lúcia Euzébio Ribeiro, M. Gomes Gouveia, L. H. Dias, D. Veghini, R. Casian Tuão, K. Rosemarie Lallemand Tapia, M. Barbosa Beloni Lirio, M. Deorce de Lima, F. Faé, L. Fiorotti Albertino, J. Ribeiro de Oliveira, H. Corona, I. Ribeiro Moulaz, L. Gonçalves Rodrigues Aguiar, P. Dias Cardoso Ribeiro, V. De Oliveira Magalhães, M. Freitas de Aguiar, E. Biegelmeyer, F. M. Matos Melo Campos Peixoto, C. Kayser, A. Wagner Silva de Souza, C. Heldan de Moura Castro, C. Maria Paiva França Telles, J. Buhring, R. Lima, R. Holanda Da Silva Sanches, N. Seixas de Melo, C. Ruas Yasuda, N. Sartori, V. Hax, R. Cavalheiro Do Espírito Santo, R. Poubel Vieira de Rezende, K. Lino Baptista, N. Rodrigues Querido Fortes, A. K. Melo, T. Santos Melo, V. Cruz, J. Rêgo, R. Maria Rodrigues Vieira, A. Sophia Rodrigues Vieira, A. M. Kakehasi, A. C. Faria Moreira Gomes Tavares, A. Teixeira de Landa, P. Costa, V. F. Azevedo, O. Assis Martins-Filho, V. Peruhype-Magalhães, M. Pinheiro, E. I. Sato, O. A. Monticielo, R. Machado Xavier, A. Teixeira-Carvalho, V. Angelina de Souza, G. Ferreira, V. Valim, G. Salviato Pileggi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Breakthrough COVID-19 infections occurring in fully vaccinated people have been described. There is particular concern about the effectiveness of vaccination in patients with immune-mediated rheumatic diseases (IMRD). Data on the characteristics and prognosis of breakthrough COVID-19 among IMRD patients are scarce. <h3>Objectives:</h3> To describe demographic and clinical characteristics, COVID-19 presentation, and risk factors associated with hospitalization in this population. <h3>Methods:</h3> SAFER study is a Brazilian multicentric cohort evaluating safety and effectiveness of SARS-Cov-2 vaccines in patients with autoimmune diseases, ongoing since April, 2021. In this study, 1,128 fully vaccinated adult IMRD patients were analyzed. It describes the fully vaccinated IMRD patients presenting breakthrough COVID-19 (occurring ≥14 days after the second dose in a two-dose series or ≥14 days after a single-dose vaccine), from April, 2021 to February, 2023. Descriptive analysis, and a regression model to evaluate the variables associated with hospitalization due to COVID-19, were performed. The significant p-value was &lt; 0.05. <h3>Results:</h3> 160 fully vaccinated IMRD patients surviving breakthrough COVID-19 were included. Patients received 2 (19%), 3 (70%) or 4 (11%) vaccine doses. The initial two-dose series was mainly with ChAdOx1 (Oxford/AstraZeneca) (58%) or BBIBP-CorV (Sinopharm-Beijing) (34%). The first booster (n=150), with BNT162b2 (BioNtech/Fosun Pharma/Pfizer) (63%) or ChAdOx1 (Oxford/AstraZeneca) (29%), and the second booster (n=112) with BNT162b2 (BioNtech/Fosun Pharma/Pfizer) (40%) or ChAdOx1 (Oxford/AstraZeneca) (26%). The characteristics of the population are shown in Table 1. Most (96%) patients reported COVID-19 symptoms, mainly headache (57%), cough (54%), rhinorrhea (51%), sore throat (49%), fever (46%), fatigue (32%), hyposmia (20%), dysgeusia (18%), and dyspnea (18%). Binary logistic regression for hospitalization due to breakthrough COVID-19 is in Table 2. <h3>Conclusion:</h3> Booster vaccine doses decreases, while higher disease activity or chronic use of corticosteroids increases the risk of hospitalization due to breakthrough COVID-19 infection in IMRD vaccinated patients. Fever or dyspnea in COVID-19 infection predict hospitalization in this population. New studies to evaluate the impact of breakthrough COVID-19 and the effects of vaccine booster doses in these patients are warranted. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> We thank SAFER Study Group and the Brazilian Society of Rheumatology for supporting this study. This study was financed by the Brazilian Department of Science and Technology (TED 20/2021). <h3>Disclosure of Interests:</h3> <b>None declared.</b>