medwireNews: People on immunomodulatory therapy have similar rates of breakthrough SARS-CoV-2 infection to healthy controls, with a reduced risk seen in those with prior infection or seroconversion after vaccination, research suggests.
Filip Eftimov (University of Amsterdam, the Netherlands) and team found that 3207 patients on immunomodulatory therapy for immune-mediated inflammatory diseases (IMIDs) and a control group of 1807 people had identical rates of breakthrough infection with the B.1.617.2 (delta) variant of SARS-CoV-2 following vaccination, at 8.0 per 1000 months. The control group comprised 985 IMID patients who were not on immunomodulatory therapy and 822 healthy individuals.
Infection severity was also similar in the two groups, and “infections were mostly mild or asymptomatic,” note the researchers in The Lancet Rheumatology.
While immunomodulatory therapy use did not impact breakthrough infection risk, multivariable analysis showed that people with seroconversion after vaccination – defined as titers of antibodies against the receptor binding domain of the SARS-CoV-2 spike protein of at least 4 AU/mL – had a significantly lower risk for infection than those without (odds ratio [OR]=0.58), as did those with prior COVID-19 (OR=0.34).
In an accompanying commentary, Alfred Kim (Washington University School of Medicine, St Louis, Missouri, USA) and Jeffrey Sparks (Brigham and Women’s Hospital, Boston, Massachusetts, USA) say that these findings are “reassuring” and “offer some evidence that humoral responses confer clinical protection.”
They note, however, that “the specific threshold that offers protection remains unclear.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group
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