ABSTRACT
BACKGROUND: Data on the effectiveness of SARS-CoV-2 vaccines and the durability of protection against the prevalent Omicron variant are scarce, especially in patients with autoimmune rheumatic diseases (AIRDs). Hence, we prospectively studied Omicron breakthrough infections in patients with AIRDs and attempted to isolate associated risk factors. METHODS: Patients with AIRDs who had completed primary vaccination with either AZD1222 or BBV152 vaccines were included and prospectively followed up from January 2022 onwards for the development of breakthrough Omicron infections. The time interval from the last event [2nd dose of vaccination (V) or past COVID-19 infection (I) whichever was later] to Omicron infection was recorded. Patients were divided based on the events and their order of occurrence into V + V, V + I, I + V, V + I + V, and V + V + I groups. The incidence of breakthrough infections and their predictors were studied with a focus on the vaccine type and hybrid (H) immunity (vaccinated individuals with a history of COVID-19 infection). RESULTS: We included 907 patients with AIRDs (53.5 ± 11.7 years and a male-to-female ratio of 1:5.1), and the majority of patients had received AZD1222 (755, 83.2%). Breakthrough infections were observed in 158 of 907(17.4%) of which 97 (10.4%) were confirmed by RT-PCR. Breakthrough infections were significantly greater in the V versus the H group (15.7% and 3.5%, log-rank test, p = < 0.01). Among the hybrid group, the order of infection and vaccination had no bearing on the risk of breakthrough infections. On multivariate analysis, breakthrough infections were significantly lesser in the H versus the V group [HR: 0.2(0.1-0.4); p = 0.01]. CONCLUSION: The risk of breakthrough Omicron infections in fully vaccinated patients with AIRDs was 17.4% with a significantly lower risk in patients with hybrid immunity.
Subject(s)
Autoimmune Diseases , COVID-19 , Rheumatic Diseases , Humans , Female , Male , COVID-19 Vaccines , ChAdOx1 nCoV-19 , Prospective Studies , SARS-CoV-2 , Breakthrough InfectionsABSTRACT
BACKGROUND: Globally 220 countries and territories are affected and cases of COVID-19 have increased by 8% resulting in 3.6 million new cases. The most common symptoms include fever, cough, loss of taste or smell, headache and mortality rate was uncertain. The objective of this study is to know the clinical profile and outcomes of COVID-19 positive patients. METHODOLOGY: A Cross-Sectional Study was conducted for 2 months (October-December 2020) among 727 COVID 19 positive patients residing in the field practice area of 4 health centers. Details regarding medical history, exposure history, underlying co-morbidities, symptoms, signs clinical features and outcomes (i.e, cured, mortality, and length of stay) were obtained. RESULTS: The mean age of participants was 41 ± 17 years, 59.28% were males, 40.71% were females. A significant association was found between age, family history of disease, co-morbid disease, medication history, smoking habit, alcohol consumption, type of symptoms, isolation type, treatment given with outcomes (P < 0.05). Subjects with previous history of medication (HR, 2.749; 95% CI 1.0774-7.015), and those who had symptoms (HR, 3.6446; 95% CI1.0280-12.921) were associated with increased risk of death as compared to others. CONCLUSION: COVID-19 positive was found in 56% of patients, they were less severe and improved with medication and deaths were found in 3.85% of patients. Fever was noted in only 15.72% of patients, gastrointestinal symptoms in 1.22% and respiratory symptoms in 14.74% of patients. Participants with older age were significantly associated with complications and those with co-morbidities were significantly associated with death on multinominal logistic analysis.