Impact of vaccination on post-acute sequelae of SARS CoV-2 infection in patients with rheumatic diseases

hapl808

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Thought this preprint was interesting as most studies ignore people who have various autoimmune conditions, and we respond very differently.

https://www.medrxiv.org/content/10.1101/2022.10.06.22280798v1

Results: Among 280 patients, the mean age was 53 years, 80% were female, and 82% were white. The most common SARDs were inflammatory arthritis (59%) and connective tissue disease (24%). Those with breakthrough infection had more upper respiratory symptoms, and those with non-breakthrough infection had more anosmia, dysgeusia, and joint pain. Compared to those with non-breakthrough COVID-19 infection (n=164), those with breakthrough infection (n=116) had significantly more symptom-free days over the follow-up period (+28.9 days, 95% CI: 8.83, 48.89; p=0.005) and lower odds of PASC at 28 and 90 days (aOR 0.49, 95% CI: 0.29, 0.83 and aOR 0.10, 95% CI: 0.04, 0.22, respectively). Conclusion: Vaccinated patients with SARDs were less likely to experience PASC compared to those not fully vaccinated. These findings support the benefits of vaccination for patients with SARDs and suggest that the immune response to acute infection is important in the pathogenesis of PASC in SARD patients.
 

hapl808

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Upon further reading, some weird limitations like all these studies.

They included partially vaccinated with unvaccinated. The breakthrough infection group was 15% obese, the non-breakthrough group was 25% obese. Almost all the breakthroughs were Omicron with a few Delta, and all the non-breakthroughs were wild type with a few Delta.

So many confounders that I don't know what to conclude.

In addition, the aOR calculation seems a bit weird to me?

Those with breakthrough infection were less likely to have PASC at 28 days (41% vs. 54%, p=0.04) and at 90 days (21% vs. 41%, p<0.0001) (Table 3; Figure 1), corresponding to a lower odds of PASC at 28 days (aOR 0.49, 95% CI: 0.29, 0.83) and 90 days (aOR 0.10, 95% CI: 0.04, 0.22).