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COVID-19 breakthrough infections in rheumatic diseases patients after vaccination.
Alshukairi, Abeer N; Al-Omari, Awad; Albeity, Abdurahman; Alandijany, Thamir A; Hassan, Ahmed M; El-Kafrawy, Sherif A; Dada, Ashraf; Al Hroub, Mohammad K; El-Saed, Aiman; Bissar, Lina S; Daghmush, Radwan M; Al-Ghamdi, Saeed M G; Perlman, Stanley; Azhar, Esam I; Halabi, Hussein.
  • Alshukairi AN; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia; College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia. Electronic address: abeer.alshukairi@gmail.com.
  • Al-Omari A; College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia; Department of Critical Care, Dr Sulaiman Al Habib Medical Group, Riyadh, Kingdom of Saudi Arabia.
  • Albeity A; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
  • Alandijany TA; Special Infectious Agents Unit - BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
  • Hassan AM; Special Infectious Agents Unit - BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
  • El-Kafrawy SA; Special Infectious Agents Unit - BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
  • Dada A; College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia; Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
  • Al Hroub MK; Department of Infection Control and Hospital Epidemiology, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
  • El-Saed A; Department of Infection Prevention and Control, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia.
  • Bissar LS; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia; Volunteer Faculty, Irvine School of Medicine, University of California, California, USA.
  • Daghmush RM; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
  • Al-Ghamdi SMG; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
  • Perlman S; Department of Microbiology and Immunology, Department of Pediatrics, University of Iowa, Iowa City, USA.
  • Azhar EI; Special Infectious Agents Unit - BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. Electronic address: eazhar
  • Halabi H; Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
J Infect Public Health ; 15(6): 685-688, 2022 May 13.
Article in English | MEDLINE | ID: covidwho-1945692
ABSTRACT

BACKGROUND:

Rheumatic diseases patients receiving Rituximab had severe COVID-19 disease. Although they had impaired humoral immune responses following COVID-19 vaccine, they had preserved cellular immune responses. Waning of COVID-19 antibody responses was observed within six months post vaccination among immunocompromised patients. Recent reports showed fatal outcome of breakthrough SARS-CoV-2 infections among vaccinated high-risk rheumatic diseases patients receiving Rituximab. SAR-CoV-2 serological tests were not performed.

OBJECTIVE:

Evaluation of COVID-19 vaccine humoral responses and breakthrough infections among low risk fully vaccinated rheumatic patients during the Delta Variant Era.

METHODS:

A case series of 19 fully vaccinated patients with rheumatic diseases were followed to determine post vaccine SARS-CoV-2 neutralizing antibody titers and to monitor the development of breakthrough infections up to eight months post vaccine at our tertiary care center in Jeddah, Saudi Arabia from 1st April until 30th November 2021.

RESULTS:

The mean age of patients was 49 years old. 10% of patients were receiving Rituximab. 73% of patients had positive SARS-CoV-2 serological testing post second vaccine. Two mild breakthrough COVID-19 infections were diagnosed six months post second dose of vaccine. Patients were less than 65 years, did not receive Rituximab, did not have interstitial lung diseases and had positive post vaccine serological testing.

CONCLUSIONS:

We demonstrated high SARS-CoV-2 neutralizing antibodies seroprevalence and self-limiting breakthrough infections in low risk rheumatic diseases patients during the Delta Era. Future studies are needed to study the outcome of rheumatic diseases patients in the Era of Omicron in view of viral immune escape responses.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Topics: Vaccines / Variants Language: English Journal: J Infect Public Health Journal subject: Communicable Diseases / Public Health Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Topics: Vaccines / Variants Language: English Journal: J Infect Public Health Journal subject: Communicable Diseases / Public Health Year: 2022 Document Type: Article