COVID-19 breakthrough infections in rheumatic diseases patients after vaccination

Journal of Infection and Public Health

Awad Al-Omari¹  Abdurahman Albeity²  Ahmed M. Hassan³  Lina S. Bissar⁴  Mohammad K. Al Hroub⁴  Saeed M.G. Al-Ghamdi⁴  Esam I. Azhar⁵  Stanley Perlman⁶  Thamir A. Alandijany⁶  Hussein Halabi⁷  Sherif A. El-Kafrawy⁸  Abeer N. Alshukairi⁸  Ashraf Dada⁹  Radwan M. Daghmush⁹  Aiman El-Saed⁹ 

[1] College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia;Correspondence to: Adult Infectious Diseases Section, Department of Medicine, King Faisal Specialist Hospital and Research Center,PO BOX 40047, Jeddah 21499, Kingdom of Saudi Arabia.;Department of Critical Care, Dr Sulaiman Al Habib Medical Group, Riyadh, Kingdom of Saudi Arabia;Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia;College of Medicine, AlFaisal University, Riyadh, Kingdom of Saudi Arabia;Department of Infection Control and Hospital Epidemiology, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia;Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia;Special Infectious Agents Unit – BSL3, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia;

关键词: Breakthrough infection;    COVID-19;    Outcome;    Rheumatic diseases;    Vaccine;   

DOI  :  

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown