Table 2 Characteristics of patients with breakthrough SARS-CoV-2 infection.

From: One-year breakthrough SARS-CoV-2 infection and correlates of protection in fully vaccinated hematological patients

Characteristics

SARS-CoV-2 infection (n = 266)

Prior COVID-19, n/n evaluable (%)

14/129 (10.8)

Type of 1st and 2nd vaccines, n/n evaluable (%)

 

• Moderna mRNA-1273

189/1086 (17.4)

• Pfizer-BioNTech BNT162b2

68/410 (16.6)

• Adenoviral vector-based

9/55 (16.4)

Type of 3rd vaccines before SARS-CoV-2 breakthrough, n evaluable (%)

185 (69)

• Moderna mRNA-1273

133 (71.8)

• Pfizer-BioNTech BNT162b2

50 (27)

• Adenoviral vector-based

2 (1)

Likely SARS-CoV-2 variantsa, n (%)

 

• Alfa or Beta

18 (6.7)

• Delta

45 (17)

• Omicron

203 (76.3)

Age (years), median (range)

62 (19–97)

• 16–40 years, n/n evaluable (%)

32/167 (19.1)

• 41–60 years, n/n evaluable (%)

97/551 (17.6)

• 61–70 years, n/n evaluable (%)

60/407 (14.7)

• >71 years, n/n evaluable (%)

77/426 (18)

Male, n (%)/n evaluable (%)

165/871 (18.9)

Baseline disease, n/n evaluable (%)

 

• AML

9/50 (18)

• ALL

0/5 (0)

• MDS

22/117 (18.8)

• B cell NHL

49/260 (18.8)

• T cell NHL

5/15 (33.3)

• Plasma cell disorders

32/164 (19.5)

• CLL

44/155 (26.8)

• HD

9/65 (13.8)

• cMPN

12/127 (9.4)

• Aplastic anemia

0/4 (0)

• Non-malignant disorders

5/17 (29)

• Allo-HSCT

53/429 (12.3)

• ASCT

23/121 (19)

• CAR-T

3/22 (13.6)

Immunosuppressant drugs at vaccination, n /n evaluable (%)

64/322 (19.8)

Corticosteroids at vaccination, n /n evaluable (%)

65/278 (23.3)

Daratumumab, n /n evaluable (%)

11/52 (21.1)

Venetoclax, n /n evaluable (%)

6/16 (37.5)

Anti-CD-20 moAb, n /n evaluable (%)

50/270 (18.5)

• <6 months before 1st vaccine dose

22/97 (22.6)

• 6 to 1 year before 1st vaccine dose

4/25 (16)

• >1 year before 1st vaccine dose

24/148 (16.2)

BTK inhibitor therapy, n /n evaluable (%)

17/67 (25.3)

TKI therapy, n /n evaluable (%)

12/49 (24.5)

Lenalidomide, n /n evaluable (%)

31/129 (24)

Ruxolitinib therapy, n /n evaluable (%)

1/15 (6)

Timing and characteristics of breakthrough SARS-CoV-2 infection

 

SARS-CoV-2 infection after 2 vaccine doses and before booster/s, n (%)

76 (30)

• Median time, days (range)

158 (7–391)

SARS-CoV-2 infection after 3 vaccine doses and before the 4th dose, n (%)

165 (62)

• Median time, days (range)

121 (1–280)

SARS-CoV-2 infection after 4 vaccine doses, n (%)

25 (8)

• Median time, days (range)

24 (1–115)

Number of evaluable SARS-CoV-2 infections after each serological time point, n (%)

 

• After 3–6 weeks from 2 doses

240 (90)

• After 3 months from 2 doses

207 (77.8)

• After 6 months from 2 doses

166 (62)

• After 1 year from 2 doses

37 (14)

SCoV2-R-A detection at 3–6 weeks, n /n evaluable (%)

170/240 (70.8)

Median SCoV2-R-A titer at 3–6 weeks, BAU/mL (range)

202 (0–10400)

SCoV2-R-A detection at 3 months, n /n evaluable (%)

137/200 (68.5)

Median SCoV2-R-A titer at 3 months, BAU/mL (range)

99 (0–15846)

SCoV2-R-A detection at 6 months, n /n evaluable (%)

120/161 (74)

Median SCoV2-R-A titer at 6 months, BAU/mL (range)

302 (0–48856)

SCoV2-R-A detection at 1 year, n /n evaluable (%)

27/37 (73)

Median SCoV2-R-A titer at 1 year, BAU/mL (range)

1017 (0–6423)

Symptomatic SARS-CoV-2 infection, n /n evaluable (%)

145/266 (54.5)

Pneumonia, n /n evaluable (%)

49/266 (18.4)

Hospital admission, n /n evaluable (%)

48/266 (18)

Oxygen requirement, n /n evaluable (%)

36/266 (13.5)

ICU admission, n /n evaluable (%)

5/266 (1.9)

COVID-related Death, n /n evaluable (%)

5/266 (1.9)

All-cause mortality at median follow-up, n /n evaluable (%)

12/266 (4.5)

  1. AML acute myeloid leukemia, ALL acute lymphoblastic leukemia, MDS myelodysplastic syndrome, B-cell NHL B-cell non-Hodgkin lymphoma, T cell NHL T cell non-Hodgkin lymphoma, CLL chronic lymphocytic leukemia, HD Hodgkin disease, MPN chronic myeloproliferative neoplasm, Allo-HSCT allogeneic stem cell transplantation, ASCT autologous stem cell transplantation, CAR-T T-cell chimeric antigen receptor, moAb monoclonal antibody, BTK inhibitor Bruton’s tyrosine kinase inhibitor, TKIs tyrosine kinase inhibitors, SCoV2-R-A SARS-CoV-2-reactive IgG antibodies, Anti-N SARS-CoV-2 nucleocapsid antibodies, ICU intensive care unit.
  2. aAccording to the Spanish epidemiological data regarding the predominance of each SARS-CoV-2 variant during the time of the study period, we considered Alfa or Beta VOC the episodes of SARS-CoV-2 infection diagnosed between April 1, 2021 and July 26, 2021, Delta VOC between July 27, 2021 and Omicron between December 27, 2021 to July 31, 2022.
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