Table 2.
Characteristics of patients with breakthrough SARS-CoV-2 infection
| Characteristics | SARS-CoV-2 infection (n = 37) |
|---|---|
| Prior COVID-19, n /n evaluable (%) | 0/109 |
| Type of vaccine, n/n evaluable (%) | |
| Moderna mRNA-1273 | 24/982 (2.4) |
| Pfizer-BioNTech BNT162b2 | 11/362 (3) |
| Adenoviral vector-based | 2/50 (4) |
| Age (years), n/n evaluable (%) | |
| 18–40 years | 6/144 (4.2) |
| 41–60 years | 17/495 (3.4) |
| 61–70 years | 6/373 (1.6) |
| > 71 years | 8/382 (2) |
| Male, n (%)/n evaluable (%) | 25/784 (3.2) |
| Baseline disease, n/n evaluable (%) | |
| AML | 5/180 (2.7) |
| ALL | 1/46 (2.1) |
| MDS | 5/158 (3.1) |
| B-cell NHL | 5/301 (1.7) |
| T cell NHL | 3/38 (8) |
| Plasma cell disorders | 5/236 (2.1) |
| CLL | 4/158 (2.5) |
| HD | 6/103 (5.8) |
| cMPN | 2/139 (1.4) |
| Aplastic anemia | 0/16 |
| Non-malignant disorders | 1/17 (5.5) |
| Cell therapy, n /n evaluable (%) | 18/501 (3.6) |
| Type of cell therapy, n /n evaluable (%) | |
| Allo-HSCT | 13/370 (3.5) |
| ASCT | 5/110 (4.7) |
| CAR-T | 0/21 |
| Status disease at vaccination, n /n evaluable (%) | |
| Complete remission | 21/825 (2.5) |
| Partial remission | 6/162 (3.7) |
| Active disease | 10/407 (2.4) |
| Time last treatment to COVID-19 vaccine, n /n evaluable (%) | |
| Untreated | 7/172 (4) |
| Active treatment | 10/509 (1.9) |
| ≥ 6 month to 1 year | 5/92 (5.4) |
| ≥ 1 year | 15/620 (2.4) |
| Immunosuppressant drugs at vaccination, n /n evaluable (%) | 13/300 (4.3) |
| Corticosteroids at vaccination, n /n evaluable (%) | 8/255 (3.1) |
| Daratumumab, n /n evaluable (%) | 1/46 (2.1) |
| Venetoclax, n /n evaluable (%) | 0/14 |
| Anti-CD-20 moAb, n /n evaluable (%) | 4/241 (1.6) |
| BTK inhibitor therapy, n /n evaluable (%) | 3/63 (4.7) |
| TKI therapy, n /n evaluable (%) | 1/40 (2.5) |
| Lenalidomide, n /n evaluable (%) | 2/120 (1.7) |
| Ruxolitinib therapy, n /n evaluable (%) | 0/14 |
| Absolute lymphocyte counts < 1 × 109/L, n /n evaluable (%) | 9/260 (3.4) |
| Intervals from 2nd dose to SARS-CoV-2 infection, n /n patients at risk (%) | |
| At 30 days after 2nd dose | 14/1361 (1) |
| At 60 days after 2nd dose | 3/1309 (0.2) |
| At 90 days after 2nd dose | 8/1227 (0.6) |
| At 180 days after 2nd dose | 12/518 (2.3) |
| SCoV2-R-A detection at 3–6 weeks, n /n evaluable (%) | 17/30 (57) |
| Median SCoV2-R-A titer at 3–6 weeks, BAU/mL (range) [27 evaluable patients] | 1.83 (0–4854.95) |
| SARS-CoV-2 infection after the third vaccine dose, n (%) | 2/541 (0.3) |
| SARS-CoV-2 diagnosis, n /n evaluable (%) | |
| PCR | 22/37 (60) |
| Seroconversion of anti-N antibodies | 15/37 (40) |
| Symptomatic SARS-CoV-2 infection, n /n evaluable (%) | 18/37 (48.6) |
| Pneumonia, n /n evaluable (%) | 7/37 (19) |
| Hospital admission, n /n evaluable (%) | 12/37 (32) |
| Oxygen requirement, n /n evaluable (%) | 10/37 (27) |
| ICU admission, n /n evaluable (%) | 3/37 (8) |
| Death, n /n evaluable (%) | 3/37 (8) |
| Median time to death from 2nd vaccine dose, days (range) | 82 (59–100) |
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; and ICU, intensive care unit