Breakthrough SARS-CoV-2 infections with the delta (B.1.617.2) variant in vaccinated patients with immune-mediated inflammatory diseases using immunosuppressants: a substudy of two prospective cohort studies

COVID-19 vaccine effectiveness against omicron (B.1.1.529) variant infection and hospitalisation in patients taking immunosuppressive medications: a retrospective cohort study

“…Another study did not find increased risk of SARS-CoV-2 infection among vaccinated immunosuppressed people compared with the immunocompetent vaccinated population. 26 Compared with our study, that study had information on underlying immune-mediated inflammatory diseases but used a less restrictive definition of immunosuppression and did not account for a higher incidence of third vaccine doses in the immunosuppressed population. Nonetheless, all of these findings could be consistent with increased risk of SARS-CoV-2 infection associated with some specific potent immunosuppressants but not with other immunosuppressant medications.…”

Immunosuppression and SARS-CoV-2 breakthrough infections

“…In The Lancet Rheumatology , Laura Boekel and colleaguges 8 extend these observations during the second half of 2021 (when the delta [B.1.617.2] variant of SARS-CoV-2 was dominant in Europe) by pooling two large Dutch cohorts: Target-to-B! (T2B!)…”

SARS-CoV-2 breakthrough infections in patients with immune-mediated inflammatory diseases during the omicron dominant period

“… 2 , 3 Reassuringly, we previously observed that the incidence and severity of breakthrough infections during the period in which the delta (B.1.617.2) variant of SARS-CoV-2 was dominant were generally similar in patients with immune-mediated inflammatory diseases receiving immunosuppressants and healthy controls, except for those receiving anti-CD20 therapy. 4 However, there is still a paucity of clinical data from patients with immune-mediated inflammatory diseases regarding infections caused by the omicron variant. Therefore, we compared the severity of SARS-CoV-2 breakthrough infections during the time period when the omicron (BA.1 and BA.2 lineages) variant was dominant between patients with immune-mediated inflammatory diseases treated with different immunosuppressants and healthy controls, and we assessed how this severity differed from infections when previous SARS-CoV-2 variants were dominant.…”

“…Online questionnaires were used for collection of demographic and clinical data, and information on SARS-CoV-2 vaccination, as described previously. 4 , 5 Questionnaires to collect data on SARS-CoV-2 breakthrough infections were sent to participants at fixed timepoints: April 26, Aug 24, and Dec 10, 2021, 4 and March 10, 2022. Breakthrough infections were classified as delta or omicron SARS-CoV-2 infections on the basis of publicly available data on the predominant circulating SARS-CoV-2 variant in the Netherlands at the time ( appendix p 4 ).…”

“…Other objectives were to compare the risk of hospitalisation due to omicron breakthrough infections with the risk due to wild-type or alpha (B.1.1.7) variants of SARS-CoV-2 and delta breakthrough infections in patients with immune-mediated inflammatory diseases, and to assess effects of anti-CD20 therapy on the risk of hospitalisation due to omicron breakthrough infections. Additionally, because we previously found significant associations between clinical determinants and the occurrence of delta breakthrough infections, 4 we aimed to explore these potential associations for omicron breakthrough infections.…”