Table 1.
Baseline Characteristics and Outcomes of all Patients With COVID-19 Breakthrough Infection, Including Univariate Analysis of COVID-19-Related Hospitalization
| Baseline Characteristics | Total Patients | Not Hospitalized for COVID-19a | Hospitalized for COVID-19 | P Value | |
|---|---|---|---|---|---|
| N = 982 | n = 828 | n = 154 | |||
| Vaccine type | No. (%) | <.001 | |||
| JNJ78436735 | 57 (6) | 39 (5) | 18 (12) | ||
| mRNA1273 | 185 (19) | 145 (18) | 43 (28) | ||
| BNT162b2 | 737 (75) | 644 (78) | 93 (60) | ||
| Age | Mean ± SD | 57.9 ± 18 | 55.2 ± 17.7 | 72.6 ± 13.8 | <.001 |
| Male sex | No. (%) | 417 (43) | 339 (41) | 78 (51) | .025 |
| Race/ethnicity | No. (%) | .728 | |||
| White | 774 (79) | 655 (79) | 119 (77) | ||
| Black | 107 (11) | 86 (10) | 21 (14) | ||
| Latino | 21 (2) | 18 (2) | 3 (2) | ||
| Other | 80 (8) | 69 (8) | 11 (7) | ||
| Health care worker | No. (%) | 255 (26.0) | 252 (30) | 3 (2) | <.001 |
| No. of total comorbidities | Median [IQR] | 2 [0–4] | 1 [0–3] | 4 [2–6] | <.001 |
| Body mass index | No. (%) | .634 | |||
| 30–39 kg/m2 | 261 (26.6) | 215 (33) | 46 (30) | ||
| ≥40 kg/m2 | 76 (7.7) | 59 (9) | 17 (11) | ||
| Smoking history | No. (%) | 383 (39.0) | 306 (37) | 77 (50) | .002 |
| Substance abuse | No. (%) | 63 (6.4) | 54 (7) | 9 (6) | .859 |
| Chronic kidney disease | No. (%) | 69 (7.0) | 42 (5) | 27 (18) | <.001 |
| ESRD | No. (%) | 12 (1.2) | 5 (1) | 7 (5) | <.001 |
| COPD | No. (%) | 112 (11.4) | 75 (9) | 37 (24) | <.001 |
| Asthma | No. (%) | 126 (12.8) | 113 (14) | 13 (8) | .088 |
| Pulmonary hypertension | No. (%) | 8 (0.8) | 8 (1) | 0 (0) | .619 |
| Interstitial lung disease | No. (%) | 2 (0.2) | 2 (0) | 0 (0) | 1.00 |
| Obstructive sleep apnea | No. (%) | 123 (12.5) | 100 (12) | 23 (15) | .353 |
| Diabetes mellitus | No. (%) | 207 (21.1) | 151 (18) | 56 (36) | <.001 |
| Cardiovascular disease | No. (%) | 142 (15) | 90 (11) | 56 (36) | <.001 |
| Hypertension | No. (%) | 444 (45.2) | 338 (41) | 106 (69) | <.001 |
| Cirrhosis | No. (%) | 16 (1.6) | 11 (1) | 5 (3) | .091 |
| Inflammatory bowel disease | No. (%) | 24 (2.4) | 13 (2) | 11 (7) | .112 |
| Rheumatoid arthritis | No. (%) | 10 (1.0) | 6 (1) | 4 (3) | .057 |
| Systemic lupus | No. (%) | 11 (1.1) | 7 (1) | 4 (3) | .078 |
| Sarcoidosis | No. (%) | 5 (0.5) | 3 (0) | 2 (1) | .177 |
| Immunocompromised | No. (%) | 225 (22.9) | 153 (18) | 72 (47) | <.001 |
| Solid organ transplant | No. (%) | 33 (3.4) | 11 (1) | 11 (7) | <.001 |
| Bone marrow transplant | No. (%) | 0 (0) | 0 (0) | 0 (0) | 1.00 |
| Active hematologic malignancy | No. (%) | 23 (2.3) | 11 (1) | 12 (8) | <.001 |
| HIV | No. (%) | 2 (0.2) | 2 (0) | 0 (0) | 1.000 |
| Systemic steroid use | No. (%) | 131 (13.3) | 85 (10) | 46 (30) | <.001 |
| On active chemotherapy | No. (%) | 63 (6.4) | 40 (5) | 23 (15) | <.001 |
| On immunosuppression | No. (%) | 69 (7.0) | 41 (5) | 28 (18) | <.001 |
| Time to breakthrough infection, db | Mean ± SD | 135 ± 61 | - | - | <.001 |
| JNJ78436735 | 99 ± 47 | - | - | ||
| mRNA1273 | 131 ± 49 | - | - | ||
| BNT162b2 | 138 ± 62 | - | - | ||
| SARS-CoV-2 PCR Ctc | Mean ± SD | 28 ± 10 | 28 ± 10 | 21 ± 5 | .003 |
| Prior COVID infection | No. (%) | 29 (3.0) | 27 (3) | 2 (1) | .296 |
| Possible reinfectiond | No. (%) | 26 (2.6) | 24 (2.7) | 2 (1) | |
| Received monoclonal antibody | No. (%) | 115 (11.7) | 104 (13) | 11 (7) | .056 |
| Symptom severity | No. (%) | <.001 | |||
| Asymptomatic | 171 (17.4) | 170 (20) | 1 (1) | ||
| Mild or moderate | 684 (69.7) | 658 (80) | 26 (17) | ||
| Severe | 89 (9.1) | 0 (0) | 89 (58) | ||
| Critical | 38 (3.9) | 0 (0) | 38 (25) | ||
| Outcomes | |||||
| ICU admission | No. (%) | - | 30 (20) | ||
| Mechanical ventilation | No. (%) | - | 19 (12) | ||
| COVID-19-related death | No. (%) | - | 19 (12) | ||
| Hospital LOS, d | Mean ± SD | - | 6.71 ± 6.34 | ||
| 30-d readmission | No. (%) | - | 11 (7) | ||
Mean is presented with standard deviation; median is presented with interquartile range. Significant P values are bolded.
Abbreviations: ANOVA, analysis of variance; BNT162b2, Pfizer vaccine; COPD, chronic obstructive pulmonary disease; COVID-19, coronavirus disease 2019; Ct, cycle threshold; ESRD, end-stage renal disease; ICU, intensive care unit; IQR, interquartile range; JNJ78436735, Janssen vaccine; LOS, length of stay; mRNA1273, Moderna vaccine; PCR, polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.
Includes 73 patients admitted for non-COVID-19-related causes and 755 patients who were not admitted at all.
Analyzed with ANOVA of mean time to diagnosis according to vaccination type.
CT values available for 77 patients in total (60 patients not admitted for COVID-19 and 17 patients admitted for COVID-19).
Six patients were symptomatic, with 4 having mild symptoms; Ct values for asymptomatic patients who were tested on admission or before a procedure were >30.