SARS-CoV- 2 infection among vaccinated rheumatic and musculoskeletal diseases (RMDs) patients -A tertiary hospital experience in Malaysia

ABSTRACT

Purpose: To evaluate the SARS-CoV- 2 infection rate among vaccinated RMD patients in a tertiary hospital and its associations. Methodology: This cross-sectional study was performed among adult rheumatology patients who attended follow up at our centre from 1st April 2022 to 30th April 2022. Demographics and clinical data were compared between the vaccinated patients with SARS-CoV- 2 infection, Group 1 (G1) and without SARS-CoV- 2 infection, Group 2 (G2). Descriptive and inferential statistics were conducted using SPSS version 26. Result(s) We enrolled a total of 212 patients with underlying diagnosis of rheumatoid arthritis (94 patients, 44.3%), systemic lupus erythematosus (59 patients, 27.8%), spondyloarthropathies (30 patients, 14.2%) and others (29 patients, 13.7%). Of all these patients, 57 (26.9%) had SARS-CoV- 2 infection (G1) with mean (SD) age of 45.2 (+/-14.65) years compared to 53.4 (+/-15.22) years in G2 (P = 0.001). In G1, 50 (87.7%) were female, 32 (56.1%) were Malay and 26 (45.6%) with >= 1 comorbidity. Most patients in G1 received 3 doses of vaccine (n = 36, 63.2%) while 21 (36.8%) completed 2 doses of vaccine. Majority in G1 (n = 46, 80.7%) had clinical stage 2 SARS-CoV- 2 infection. Seven required admission to health care facilities with median stay of 6 +/- 2 days. Twenty-three patients (32.9%) in G1 received more than one immunosuppressive drug. Twenty-one out of 63 patients (33.3%) who had 2 doses of SARS-CoV- 2 vaccine had SARS-CoV- 2 infection compared to 36 out of 149 patients (24.2%) who received 3 doses of vaccine, albeit not significant. Conclusion(s) Despite a quarter of the cohort acquired SARS-CoV- 2 infection, the disease was notably less severe, attributed to younger age, less comorbidity and vaccine effectiveness. Type of immunosuppression and use of more than one immunosuppressive drugs were not associated with SARS-CoV- 2 infection.