Table 1

Patient characteristics, vaccination details, medication use and infection details of COVID-19 breakthrough infections in fully vaccinated patients with SARDs (nN=16)

Patient characteristicsn, %
Female12, 75
Age (median, IQR)49.5 (38.0–64.5)
Race
 White11, 68
 Black3, 20
 Hispanic2, 13
Rheumatic disease*
 Rheumatoid arthritis6, 38
 Rheumatoid arthritis-associated interstitial lung disease1, 6
 Dermatomyositis3, 19
 Myositis-associated interstitial lung disease1, 6
 Systemic lupus erythematosus3, 19
 Ankylosing spondylitis2, 13
 IgG4-related disease1, 6
 Mixed connective tissue disease1, 6
 Hypocomplementemic urticarial vasculitis1, 6
 Psoriatic arthritis1, 6
Comorbidities*
 Hypertension6, 38
 Morbid obesity (BMI ≥40.0 kg/m2)3, 19
 Interstitial lung disease2, 13
 End-stage renal disease2, 13
 Chronic obstructive pulmonary disease1, 6
 Asthma1, 6
 Diabetes1, 6
 Obesity (BMI ≥30.0 kg/m2)1, 6
 Coronary artery disease1, 6
 Cancer1, 6
 Organ transplant1, 6
 Immunodeficiency1, 6
 Chronic neurological or neuromuscular disease1, 6
 Inflammatory bowel disease1, 6
 None4, 25
Smoking status
 Current1, 6
 Former7, 44
 Never6, 38
 Unknown2, 13
Vaccination details n, %
Vaccine type
 Pfizer-BioNtech7, 44
 Moderna5, 31
 Janssen/Johnson & Johnson4, 25
Disease activity at vaccination
 First vaccination
  Active5, 31
  Inactive11, 69
 Second vaccination
  Active6, 38
  Inactive6, 38
  Not applicable4, 25
Rheumatic disease treatment use prior to first vaccine dose† n, %
Rituximab5, 31
Glucocorticoids5, 31
Mycophenolate mofetil or mycophenolic acid4, 25
Methotrexate3, 19
Tacrolimus2, 13
Adalimumab1, 6
Azathioprine1, 6
Belimumab1, 6
Hydroxychloroquine1, 6
Intravenous immunoglobulin1, 6
Sulfasalazine1, 6
Tocilizumab1, 6
Ustekinumab1, 6
None1, 6
COVID-19 infection details n, %
Time (days) from second/final vaccine dose to infection (median, IQR)54.0 (29.8–79.0)
Infection acquisition
 Close contact with confirmed or probable case of COVID-194, 25
 Presence in a healthcare facility with COVID-19 cases3, 19
 Community acquired3, 19
 Unknown8, 50
Treatment
 No treatment/supportive care only7, 44
 Remdesivir6, 38
 Glucocorticoids3, 19
 Neutralising monoclonal antibody4, 25
 Azithromycin2, 13
 Convalescent plasma1, 6
 Enrolled in clinical trial‡1, 6
Any symptoms
 Yes15, 93
 No§1, 6
Symptoms
 Fever9, 56
 Cough7, 44
 Malaise6, 38
 Myalgia5, 31
 Rhinorrhea5, 31
 Headache4, 25
 Shortness of breath4, 25
 Sore throat4, 25
 Diarrhoea/vomiting/nausea3, 19
 Anosmia3, 19
 Dysgeusia3, 19
 Chest pain2, 13
 Arthralgia1, 6
 Other1, 6
Outcomes n, %
Outpatient management alone10, 63
Hospitalisation6, 38
Ventilation1, 6
Death2, 13
Unresolved symptoms2, 13

  • *Patients may have >1 SARD or comorbidity.

  • †One patient initiated methotrexate in between the first and second dose and one patient initiated rituximab between the second dose and infection.

  • ‡NCT04501978; phase 3 randomised, blinded, trial assessing treatments for hospitalised patients with COVID-19. Intervention arms: investigational drug+standard of care (remdesivir) or placebo+standard of care (remdesivir).

  • §Diagnosed via pre-procedure PCR test, no reported symptoms in electronic health record.

  • ¶Symptoms were unresolved (one active infection recent diagnosed, one reporting ongoing symptoms: fatigue/malaise) in two (13%) cases.

  • BMI, body mass index; SARD, systemic autoimmune rheumatic disease.