TABLE 3.
Multivariable Cox proportional hazard model for the adjusted risk of breakthrough COVID-recipients overall and by COVID-19 period
| Variable | All periods, HR (95% CI) | All periods (organ specific), HR (95% CI) | Pre-Delta wave, HR (95% CI) | Delta wave, HR (95% CI) | Omicron wave, HR (95% CI) |
|---|---|---|---|---|---|
| Vaccination status | |||||
| VAX2 | Ref | Ref | – | – | – |
| VAX3 | 0.33 (0.33, 0.33) | 0.33 (0.33, 0.33) | – | – | – |
| Pre-vaccination COVID infection | 0.18 (0.18, 0.19) | 0.18 (0.18, 0.19) | – | – | – |
| Sex | |||||
| Male | 0.89 (0.89, 0.90) | 0.89 (0.89, 0.90) | 0.97 (0.93, 1.02) | 0.94 (0.93, 0.95) | 0.86 (0.85, 0.87) |
| Female | Ref | Ref | Ref | Ref | Ref |
| Age (median) | |||||
| 18–45 | Ref | Ref | Ref | Ref | Ref |
| 46–65 | 0.94 (0.94, 0.95) | 0.95 (0.94, 0.95) | 1.12 (1.06, 1.20) | 1.12 (1.10, 1.13) | 0.81 (0.80, 0.82) |
| >65 | 0.83 (0.82, 0.84) | 0.83 (0.82, 0.84) | 1.30 (1.21, 1.39) | 1.24 (1.22, 1.26) | 0.63 (0.62, 0.63) |
| Race/Ethnicity | |||||
| White | Ref | Ref | Ref | Ref | Ref |
| Black/African American | 0.82 (0.81, 0.82) | 0.81 (0.81, 0.82) | 1.10 (1.02, 1.20) | 0.54 (0.53, 0.55) | 1.02 (1.00, 1.03) |
| Hispanic/Latino | 0.75 (0.75, 0.76) | 0.75 (0.75, 0.76) | 1.16 (1.07, 1.25) | 0.54 (0.53, 0.55) | 0.91 (0.90, 0.92) |
| Other/Unknown | 0.61 (0.60, 0.62) | 0.61 (0.60, 0.62) | 1.18 (1.09, 1.27) | 0.53 (0.52, 0.54) | 0.78 (0.77, 0.79) |
| Comorbidities | |||||
| CKD | 1.01 (0.99, 1.02) | 1.01 (0.99, 1.02) | 1.06 (0.96, 1.17) | 1.05 (1.02, 1.08) | 1.01 (0.99, 1.03) |
| Hypertension | 1.03 (1.02, 1.03) | 1.03 (1.02, 1.03) | 0.91 (0.86, 0.98) | 1.01 (1.00, 1.03) | 1.05 (1.04, 1.06) |
| Diabetes | 1.15 (1.14, 1.16) | 1.15 (1.14, 1.16) | 1.15 (1.07, 1.23) | 1.13 (1.11, 1.15) | 1.09 (1.07, 1.10) |
| COPD/Asthma | 1.02 (1.01, 1.03) | 1.02 (1.01, 1.03) | 1.03 (0.95, 1.11) | 1.00 (0.98, 1.02) | 1.05 (1.04, 1.07) |
| Cancer | 0.82 (0.81, 0.83) | 0.82 (0.81, 0.83) | 1.19 (1.10, 1.29) | 0.84 (0.82, 0.86) | 0.85 (0.83, 0.86) |
| CAD | 0.96 (0.95, 0.98) | 0.96 (0.95, 0.98) | 0.99 (0.90, 1.09) | 0.98 (0.95, 1.00) | 0.99 (0.97, 1.01) |
| CHF | 0.93 (0.92, 0.95) | 0.93 (0.91, 0.95) | 1.22 (1.10, 1.35) | 0.95 (0.92, 0.97) | 0.97 (0.95, 0.99) |
| PVD | 0.81 (0.80, 0.82) | 0.81 (0.80, 0.82) | 0.80 (0.73, 0.88) | 0.89 (0.87, 0.91) | 0.86 (0.84, 0.87) |
| Liver | 0.85 (0.82, 0.87) | 0.86 (0.84, 0.89) | 1.13 (0.96, 1.32) | 0.87 (0.83, 0.92) | 0.88 (0.85, 0.91) |
| Obesity | |||||
| BMI > 30 | 1.19 (1.18, 1.20) | 1.19 (1.18, 1.20) | 1.06 (1.00, 1.13) | 1.23 (1.21, 1.25) | 1.12 (1.10, 1.13) |
| Missing | 3.40 (3.37, 3.42) | 3.40 (3.37, 3.42) | 1.33 (1.26, 1.41) | 3.01 (2.97, 3.05) | 2.62 (2.59, 2.65) |
| Solid organ transplant | 1.76 (1.67, 1.85) | 2.35 (1.80, 3.08) | 1.67 (1.53, 1.81) | 1.51 (1.41, 1.61) | |
| Organ type | |||||
| Kidney | 1.81 (1.70, 1.91) | ||||
| Liver | 1.39 (1.28, 1.52) | ||||
| Lung | 2.11 (1.91, 2.33) | ||||
| Heart | 1.83 (1.66, 2.02) | ||||
| Maintenance immunosuppression | |||||
| Prednisone | 1.10 (1.09, 1.11) | 1.10 (1.09, 1.11) | 0.92 (0.86, 0.99) | 1.11 (1.09, 1.12) | 1.09 (1.08, 1.11) |
| Tacrolimus | 0.88 (0.84, 0.92) | 0.89 (0.85, 0.93) | 0.81 (0.62, 1.05) | 0.81 (0.74, 0.87) | 0.92 (0.87, 0.98) |
| Cyclosporine | 0.89 (0.85, 0.93) | 0.89 (0.85, 0.93) | 1.06 (0.83, 1.35) | 0.88 (0.81, 0.94) | 0.90 (0.84, 0.95) |
| MMF | 1.27 (1.20, 1.34) | 1.25 (1.18, 1.33) | 1.76 (1.31, 2.36) | 1.14 (1.03, 1.25) | 1.20 (1.12, 1.29) |
| Induction immunosuppression | |||||
| ATG | 1.03 (0.94, 1.14) | 1.02 (0.91, 1.13) | 1.02 (0.65, 1.62) | 1.17 (0.99, 1.38) | 0.89 (0.78, 1.01) |
| Basiliximab | 1.17 (1.04, 1.31) | 1.00 (0.87, 1.14) | 1.11 (0.65, 1.88) | 0.94 (0.77, 1.16) | 1.07 (0.92, 1.23) |