免疫介导的风湿性疾病的完全接种疫苗个体中突破性 COVID-19 住院的预测因素：来自 SAFER 研究的数据。
Predictors of Hospitalization in Breakthrough COVID-19 among Fully Vaccinated Individuals with Immune-Mediated Rheumatic Diseases: Data from SAFER-Study.
作者信息
Calderaro Débora Cerqueira, Valim Valéria, Ferreira Gilda Aparecida, Machado Ketty Lysie Libardi Lira, Ribeiro Priscila Dias Cardoso, Ribeiro Sandra Lúcia Euzébio, Sartori Natalia Sarzi, de Rezende Rodrigo Poubel Vieira, de Melo Ana Karla Guedes, Cruz Vitor Alves, Vieira Adah Sophia Rodrigues, Kakehasi Adriana Maria, de Landa Aline Teixeira, Burian Ana Paula Neves, Peixoto Flávia Maria Matos Melo Campos, Telles Camila Maria Paiva França, do Espírito Santo Rafaela Cavalheiro, Baptista Katia Lino, de Oliveira Yasmin Gurtler Pinheiro, Magalhães Vanessa de Oliveira, de Lima Raquel Lima, Biegelmeyer Erika, Lorencini Pietra Zava, Teixeira-Carvalho Andréa, Dos Reis-Neto Edgard Torres, Sato Emília Inoue, Pinheiro Marcelo de Medeiros, Monticielo Odirlei André, de Souza Viviane Angelina, Xavier Ricardo Machado, Pileggi Gecilmara Salviato
机构信息
Locomotor System Department, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30130-100, MG, Brazil.
Hospital Universitário Cassiano Antônio Moraes (HUCAM), Universidade Federal do Espírito Santo (UFES), Vitória 29041-295, ES, Brazil.
出版信息
Vaccines (Basel). 2024 Sep 9;12(9):1031. doi: 10.3390/vaccines12091031.
Breakthrough COVID-19 (occurring in fully vaccinated people) has been described. Data on its characteristics among immune-mediated rheumatic disease (IMRD) patients are scarce. This study describes breakthrough COVID-19 occurring in IMRD patients participating in the SAFER-study, a Brazilian multicentric cohort evaluating the safety, effectiveness, and immunogenicity of SARS-CoV-2 vaccines in patients with autoimmune diseases. A descriptive analysis of the population and a binary logistic regression model were performed to evaluate the predictors of COVID-19-related hospitalization. A -value < 0.05 was significant. The included 160 patients were predominantly females (83.1%), with a mean (SD) age of 40.23 (13.19) years. The patients received two (19%), three (70%), or four (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) was with BNT162b2 (BioNtech/Fosun Pharma/Pfizer) (63%) or ChAdOx1 (29%). The second booster (n = 112) was with BNT162b2 (40%) or ChAdOx1 (26%). The COVID-19 hospitalization rate was 17.5%. IMRD moderate/high activity (OR: 5.84; CI: 1.9-18.5; = 0.002) and treatment with corticosteroids (OR: 2.94; CI: 1.02-8.49; = 0.0043) were associated with higher odds of hospitalization, while increasing the number of vaccine doses was protective (OR: 0.37; CI: 0.15-0.9; = 0.032). These findings, along with previous reassuring results about the safety of the COVID-19 vaccines, argue in favor of booster vaccination in IMRD patients.
突破性新冠病毒感染（发生在完全接种疫苗的人群中）已有相关描述。关于免疫介导的风湿性疾病（IMRD）患者中突破性新冠病毒感染特征的数据却很稀少。本研究描述了参与SAFER研究的IMRD患者中发生的突破性新冠病毒感染情况，SAFER研究是一项巴西多中心队列研究，旨在评估SARS-CoV-2疫苗在自身免疫性疾病患者中的安全性、有效性和免疫原性。对研究人群进行了描述性分析，并采用二元逻辑回归模型来评估新冠病毒感染相关住院的预测因素。P值<0.05具有统计学意义。纳入的160例患者主要为女性（83.1%），平均（标准差）年龄为40.23（13.19）岁。患者接受了两剂（19%）、三剂（70%）或四剂（11%）疫苗接种。最初的两剂接种主要使用ChAdOx1（牛津/阿斯利康）（58%）或BBIBP-CorV（国药集团北京生物）（34%）。首次加强针（n = 150）使用BNT162b2（复星医药/辉瑞生物科技）（63%）或ChAdOx1（29%）。第二次加强针（n = 112）使用BNT162b2（40%）或ChAdOx1（26%）。新冠病毒感染住院率为17.5%。IMRD中度/高度活动（比值比：5.84；可信区间：1.9 -18.5；P = 0.002）和使用皮质类固醇治疗（比值比：2.94；可信区间：1.02 - 8.49；P = 0.0043）与更高的住院几率相关，而增加疫苗接种剂量具有保护作用（比值比：0.37；可信区间：0.15 - 0.9；P = 0.032）。这些发现，连同先前关于新冠病毒疫苗安全性的令人安心的结果，都支持对IMRD患者进行加强接种。
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