SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

Stefano Porru; Maria Grazia Lourdes Monaco; Gianluca Spiteri; Angela Carta; Maria Diletta Pezzani; Giuseppe Lippi; Davide Gibellini; Evelina Tacconelli; Ilaria Dalla Vecchia; Emma Sala; Emanuele Sansone; Giuseppe De Palma; Carlo Bonfanti; Massimo Lombardo; Luigina Terlenghi; Enrico Pira; Ihab Mansour; Maurizio Coggiola; Catalina Ciocan; Alessandro Godono; Adonina Tardon; Marta Maria Rodriguez-Suarez; Guillermo Fernandez-Tardon; Francisco Jose Jimeno-Demuth; Rafael Vicente Castro-Delgado; Tania Iglesias Cabo; Maria Luisa Scapellato; Filippo Liviero; Angelo Moretto; Paola Mason; Sofia Pavanello; Anna Volpin; Luigi Vimercati; Silvio Tafuri; Luigi De Maria; Stefania Sponselli; Pasquale Stefanizzi; Antonio Caputi; Fabriziomaria Gobba; Alberto Modenese; Loretta Casolari; Denise Garavini; Cristiana D’Elia; Stefania Mariani; Francesca Larese Filon; Luca Cegolon; Corrado Negro; Federico Ronchese; Francesca Rui; Paola De Michieli; Nicola Murgia; Marco Dell’Omo; Giacomo Muzi; Tiziana Fiordi; Angela Gambelunghe; Ilenia Folletti; Dana Mates; Violeta Claudia Calota; Andra Neamtu; Ovidiu Perseca; Catalin Alexandru Staicu; Angelica Voinoiu; Eleonóra Fabiánová; Jana Bérešová; Zora Kľocová Adamčáková; Roman Nedela; Anna Lesňáková; Jana Holčíková; Paolo Boffetta; Mahsa Abedini; Giorgia Ditano; Shuffield Seyram Asafo; Giovanni Visci; Francesco Saverio Violante; Carlotta Zunarelli; Giuseppe Verlato

doi:10.3390/vaccines10081193

SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

Stefano Porru
, Maria Grazia Lourdes Monaco
, Gianluca Spiteri
, Angela Carta
, Maria Diletta Pezzani
, Giuseppe Lippi
, Davide Gibellini
, Evelina Tacconelli
, Ilaria Dalla Vecchia
, Emma Sala
, Emanuele Sansone
, Giuseppe De Palma
, Carlo Bonfanti
, Massimo Lombardo
, Luigina Terlenghi
, Enrico Pira
, Ihab Mansour
, Maurizio Coggiola
, Catalina Ciocan
, Alessandro Godono

Adonina Tardon, Marta Maria Rodriguez-Suarez, Guillermo Fernandez-Tardon, Francisco Jose Jimeno-Demuth, Rafael Vicente Castro-Delgado, Tania Iglesias Cabo, Maria Luisa Scapellato, Filippo Liviero, Angelo Moretto, Paola Mason, Sofia Pavanello, Anna Volpin, Luigi Vimercati, Silvio Tafuri, Luigi De Maria, Stefania Sponselli, Pasquale Stefanizzi, Antonio Caputi, Fabriziomaria Gobba, Alberto Modenese, Loretta Casolari, Denise Garavini, Cristiana D’Elia, Stefania Mariani, Francesca Larese Filon, Luca Cegolon, Corrado Negro, Federico Ronchese, Francesca Rui, Paola De Michieli, Nicola Murgia, Marco Dell’Omo, Giacomo Muzi, Tiziana Fiordi, Angela Gambelunghe, Ilenia Folletti, Dana Mates, Violeta Claudia Calota, Andra Neamtu, Ovidiu Perseca, Catalin Alexandru Staicu, Angelica Voinoiu, Eleonóra Fabiánová, Jana Bérešová, Zora Kľocová Adamčáková, Roman Nedela, Anna Lesňáková, Jana Holčíková, Paolo Boffetta, Mahsa Abedini, Giorgia Ditano, Shuffield Seyram Asafo, Giovanni Visci, Francesco Saverio Violante, Carlotta Zunarelli, Giuseppe Verlato

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.

Original language	English
Article number	1193
Journal	Vaccines
Volume	10
Issue number	8
DOIs	https://doi.org/10.3390/vaccines10081193
State	Published - Aug 2022
Externally published	Yes

Keywords

COVID-19
SARS-CoV-2 vaccination
breakthrough infections
health workers
occupational and socio-demographic determinants

Access to Document

10.3390/vaccines10081193

Cite this

Porru, S., Monaco, M. G. L., Spiteri, G., Carta, A., Pezzani, M. D., Lippi, G., Gibellini, D., Tacconelli, E., Dalla Vecchia, I., Sala, E., Sansone, E., De Palma, G., Bonfanti, C., Lombardo, M., Terlenghi, L., Pira, E., Mansour, I., Coggiola, M., Ciocan, C., ... Verlato, G. (2022). SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers. Vaccines, 10(8), Article 1193. https://doi.org/10.3390/vaccines10081193

@article{d0b0d6091e2b4b1c9b195fd8b10f4090,

title = "SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers",

abstract = "Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2\%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.",

keywords = "COVID-19, SARS-CoV-2 vaccination, breakthrough infections, health workers, occupational and socio-demographic determinants",

author = "Stefano Porru and Monaco, \{Maria Grazia Lourdes\} and Gianluca Spiteri and Angela Carta and Pezzani, \{Maria Diletta\} and Giuseppe Lippi and Davide Gibellini and Evelina Tacconelli and \{Dalla Vecchia\}, Ilaria and Emma Sala and Emanuele Sansone and \{De Palma\}, Giuseppe and Carlo Bonfanti and Massimo Lombardo and Luigina Terlenghi and Enrico Pira and Ihab Mansour and Maurizio Coggiola and Catalina Ciocan and Alessandro Godono and Adonina Tardon and Rodriguez-Suarez, \{Marta Maria\} and Guillermo Fernandez-Tardon and Jimeno-Demuth, \{Francisco Jose\} and Castro-Delgado, \{Rafael Vicente\} and \{Iglesias Cabo\}, Tania and Scapellato, \{Maria Luisa\} and Filippo Liviero and Angelo Moretto and Paola Mason and Sofia Pavanello and Anna Volpin and Luigi Vimercati and Silvio Tafuri and \{De Maria\}, Luigi and Stefania Sponselli and Pasquale Stefanizzi and Antonio Caputi and Fabriziomaria Gobba and Alberto Modenese and Loretta Casolari and Denise Garavini and Cristiana D{\textquoteright}Elia and Stefania Mariani and Filon, \{Francesca Larese\} and Luca Cegolon and Corrado Negro and Federico Ronchese and Francesca Rui and \{De Michieli\}, Paola and Nicola Murgia and Marco Dell{\textquoteright}Omo and Giacomo Muzi and Tiziana Fiordi and Angela Gambelunghe and Ilenia Folletti and Dana Mates and Calota, \{Violeta Claudia\} and Andra Neamtu and Ovidiu Perseca and Staicu, \{Catalin Alexandru\} and Angelica Voinoiu and Eleon{\'o}ra Fabi{\'a}nov{\'a} and Jana B{\'e}re{\v s}ov{\'a} and Adam{\v c}{\'a}kov{\'a}, \{Zora K{\v I}ocov{\'a}\} and Roman Nedela and Anna Les{\v n}{\'a}kov{\'a} and Jana Hol{\v c}{\'i}kov{\'a} and Paolo Boffetta and Mahsa Abedini and Giorgia Ditano and Asafo, \{Shuffield Seyram\} and Giovanni Visci and Violante, \{Francesco Saverio\} and Carlotta Zunarelli and Giuseppe Verlato",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = aug,

doi = "10.3390/vaccines10081193",

language = "English",

volume = "10",

journal = "Vaccines",

issn = "2076-393X",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "8",

}

Porru, S, Monaco, MGL, Spiteri, G, Carta, A, Pezzani, MD, Lippi, G, Gibellini, D, Tacconelli, E, Dalla Vecchia, I, Sala, E, Sansone, E, De Palma, G, Bonfanti, C, Lombardo, M, Terlenghi, L, Pira, E, Mansour, I, Coggiola, M, Ciocan, C, Godono, A, Tardon, A, Rodriguez-Suarez, MM, Fernandez-Tardon, G, Jimeno-Demuth, FJ, Castro-Delgado, RV, Iglesias Cabo, T, Scapellato, ML, Liviero, F, Moretto, A, Mason, P, Pavanello, S, Volpin, A, Vimercati, L, Tafuri, S, De Maria, L, Sponselli, S, Stefanizzi, P, Caputi, A, Gobba, F, Modenese, A, Casolari, L, Garavini, D, D’Elia, C, Mariani, S, Filon, FL, Cegolon, L, Negro, C, Ronchese, F, Rui, F, De Michieli, P, Murgia, N, Dell’Omo, M, Muzi, G, Fiordi, T, Gambelunghe, A, Folletti, I, Mates, D, Calota, VC, Neamtu, A, Perseca, O, Staicu, CA, Voinoiu, A, Fabiánová, E, Bérešová, J, Adamčáková, ZK, Nedela, R, Lesňáková, A, Holčíková, J, Boffetta, P, Abedini, M, Ditano, G, Asafo, SS, Visci, G, Violante, FS, Zunarelli, C & Verlato, G 2022, 'SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers', Vaccines, vol. 10, no. 8, 1193. https://doi.org/10.3390/vaccines10081193

TY - JOUR

T1 - SARS-CoV-2 Breakthrough Infections

T2 - Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

AU - Porru, Stefano

AU - Monaco, Maria Grazia Lourdes

AU - Spiteri, Gianluca

AU - Carta, Angela

AU - Pezzani, Maria Diletta

AU - Lippi, Giuseppe

AU - Gibellini, Davide

AU - Tacconelli, Evelina

AU - Dalla Vecchia, Ilaria

AU - Sala, Emma

AU - Sansone, Emanuele

AU - De Palma, Giuseppe

AU - Bonfanti, Carlo

AU - Lombardo, Massimo

AU - Terlenghi, Luigina

AU - Pira, Enrico

AU - Mansour, Ihab

AU - Coggiola, Maurizio

AU - Ciocan, Catalina

AU - Godono, Alessandro

AU - Tardon, Adonina

AU - Rodriguez-Suarez, Marta Maria

AU - Fernandez-Tardon, Guillermo

AU - Jimeno-Demuth, Francisco Jose

AU - Castro-Delgado, Rafael Vicente

AU - Iglesias Cabo, Tania

AU - Scapellato, Maria Luisa

AU - Liviero, Filippo

AU - Moretto, Angelo

AU - Mason, Paola

AU - Pavanello, Sofia

AU - Volpin, Anna

AU - Vimercati, Luigi

AU - Tafuri, Silvio

AU - De Maria, Luigi

AU - Sponselli, Stefania

AU - Stefanizzi, Pasquale

AU - Caputi, Antonio

AU - Gobba, Fabriziomaria

AU - Modenese, Alberto

AU - Casolari, Loretta

AU - Garavini, Denise

AU - D’Elia, Cristiana

AU - Mariani, Stefania

AU - Filon, Francesca Larese

AU - Cegolon, Luca

AU - Negro, Corrado

AU - Ronchese, Federico

AU - Rui, Francesca

AU - De Michieli, Paola

AU - Murgia, Nicola

AU - Dell’Omo, Marco

AU - Muzi, Giacomo

AU - Fiordi, Tiziana

AU - Gambelunghe, Angela

AU - Folletti, Ilenia

AU - Mates, Dana

AU - Calota, Violeta Claudia

AU - Neamtu, Andra

AU - Perseca, Ovidiu

AU - Staicu, Catalin Alexandru

AU - Voinoiu, Angelica

AU - Fabiánová, Eleonóra

AU - Bérešová, Jana

AU - Adamčáková, Zora Kľocová

AU - Nedela, Roman

AU - Lesňáková, Anna

AU - Holčíková, Jana

AU - Boffetta, Paolo

AU - Abedini, Mahsa

AU - Ditano, Giorgia

AU - Asafo, Shuffield Seyram

AU - Visci, Giovanni

AU - Violante, Francesco Saverio

AU - Zunarelli, Carlotta

AU - Verlato, Giuseppe

PY - 2022/8

Y1 - 2022/8

N2 - Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.

AB - Background: The research aimed to investigate the incidence of SARS-CoV-2 breakthrough infections and their determinants in a large European cohort of more than 60,000 health workers. Methods: A multicentric retrospective cohort study, involving 12 European centers, was carried out within the ORCHESTRA project, collecting data up to 18 November 2021 on fully vaccinated health workers. The cumulative incidence of SARS-CoV-2 breakthrough infections was investigated with its association with occupational and social–demographic characteristics (age, sex, job title, previous SARS-CoV-2 infection, antibody titer levels, and time from the vaccination course completion). Results: Among 64,172 health workers from 12 European health centers, 797 breakthrough infections were observed (cumulative incidence of 1.2%). The primary analysis using individual data on 8 out of 12 centers showed that age and previous infection significantly modified breakthrough infection rates. In the meta-analysis of aggregated data from all centers, previous SARS-CoV-2 infection and the standardized antibody titer were inversely related to the risk of breakthrough infection (p = 0.008 and p = 0.007, respectively). Conclusion: The inverse correlation of antibody titer with the risk of breakthrough infection supports the evidence that vaccination plays a primary role in infection prevention, especially in health workers. Cellular immunity, previous clinical conditions, and vaccination timing should be further investigated.

KW - COVID-19

KW - SARS-CoV-2 vaccination

KW - breakthrough infections

KW - health workers

KW - occupational and socio-demographic determinants

UR - https://www.scopus.com/pages/publications/85137389944

U2 - 10.3390/vaccines10081193

DO - 10.3390/vaccines10081193

M3 - Article

AN - SCOPUS:85137389944

SN - 2076-393X

VL - 10

JO - Vaccines

JF - Vaccines

IS - 8

M1 - 1193

ER -

SARS-CoV-2 Breakthrough Infections: Incidence and Risk Factors in a Large European Multicentric Cohort of Health Workers

Abstract

Keywords

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