COVID-19 severity and vaccine breakthrough infections in idiopathic inflammatory myopathies, other systemic autoimmune and inflammatory diseases, and healthy controls: a multicenter cross-sectional study from the COVID-19 Vaccination in Autoimmune Diseases (COVAD) survey

Objectives We aimed to compare the spectrum and severity of COVID-19 and vaccine breakthrough infections (BIs) among patients with IIMs, other systemic autoimmune and inflammatory diseases (SAIDs), and healthy controls (HCs). Methods This is a cross-sectional study with data from the COVAD study, a self-reported online global survey that collected demographics, COVID-19 history, and vaccination details from April to September 2021. Adult patients with at least one COVID-19 vaccine dose were included. BIs were defined as infections occurring > 2 weeks after any dose of vaccine. Characteristics associated with BI were analyzed with a multivariate regression analysis. Results Among 10,900 respondents [42 (30–55) years, 74%-females, 45%-Caucasians] HCs were (47%), SAIDs (42%) and IIMs (11%). Patients with IIMs reported fewer COVID-19 cases before vaccination (6.2%-IIM vs 10.5%-SAIDs vs 14.6%-HC; OR = 0.6, 95% CI 0.4–0.8, and OR = 0.3, 95% CI 0.2–0.5, respectively). BIs were uncommon (1.4%-IIM; 1.9%-SAIDs; 3.2%-HC) and occurred in 17 IIM patients, 13 of whom were on immunosuppressants, and 3(18%) required hospitalization. All-cause hospitalization was higher in patients with IIM compared to HCs [23 (30%) vs 59 (8%), OR = 2.5, 95% CI 1.2–5.1 before vaccination, and 3 (18%) vs 9 (5%), OR = 2.6, 95% CI 1.3–5.3 in BI]. In a multivariate regression analysis, age 30–60 years was associated with a lower odds of BI (OR = 0.7, 95% CI 0.5–1.0), while the use of immunosuppressants had a higher odds of BI (OR = 1.6, 95% CI 1.1–2.7). Conclusions Patients with IIMs reported fewer COVID-19 cases than HCs and other SAIDs, but had higher odds of all-cause hospitalization from COVID-19 than HCs. BIs were associated with the use of immunosuppressants and were uncommon in IIMs

Sensitivity of latent heat flux from PILPS land-surface schemes to perturbations of surface air temperature.

ABSTRACT In the PILPS Phase 2a experiment, 23 land-surface schemes were compared in an off-line control experiment using observed meteorological data from Cabauw, the Netherlands. Two simple sensitivity experiments were also undertaken in which the observed surface air temperature was artificially increased or decreased by 2 K while all other factors remained as observed. On the annual timescale, all schemes show similar responses to these perturbations in latent, sensible heat flux, and other key variables. For the 2-K increase in temperature, surface temperatures and latent heat fluxes all increase while net radiation, sensible heat fluxes, and soil moistures all decrease. The results are reversed for a 2-K temperature decrease. The changes in sensible heat fluxes and, especially, the changes in the latent heat fluxes are not linearly related to the change of temperature. Theoretically, the nonlinear relationship between air temperature and the latent heat flux is evident and due to the convex relationship between air temperature and saturation vapor pressure. A simple test shows that, the effect of the change of air temperature on the atmospheric stratification aside, this nonlinear relationship is shown in the form that the increase of the latent heat flux for a 2-K temperature increase is larger than its decrease for a 2-K temperature decrease. However, the results from the Cabauw sensitivity experiments show that the increase of the latent heat flux in the ϩ2-K experiment is smaller than the decrease of the latent heat flux in the Ϫ2-K experiment (we refer to this as the asymmetry). The analysis in this paper shows that this inconsistency between the theoretical relationship and the Cabauw sensitivity experiments results (or the asymmetry) is due to (i) the involvement of the ␤ g formulation, which is a function of a series stress factors that limited the evaporation and whose values change in the Ϯ2-K experiments, leading to strong modifications of the latent heat flux; (ii) the change of the drag coefficient induced by the changes in stratification due to the imposed air temperature changes (Ϯ2 K) in parameterizations of latent heat flux common in current land-surface schemes. Among all stress factors involved in the ␤ g formulation, the soil moisture stress in the ϩ2-K experiment induced by the increased evaporation is the main factor that contributes to the asymmetry

COVID-19 vaccination in autoimmune disease (COVAD) survey protocol

The coronavirus disease-2019 (COVID-19) pandemic continues to be a cause of unprecedented global morbidity and mortality. Whilst COVID-19 vaccination has emerged as the only tangible solution to reducing poor clinical outcomes, vaccine hesitancy continues to be an obstacle to achieving high levels of vaccine uptake. This represents particular risk to patients with autoimmune diseases, a group already at increased risk of hospitalization and poor clinical outcomes related to COVID-19 infection. Whilst there is a paucity of long-term safety and efficacy data of COVID-19 vaccination in patients with autoimmune diseases, the current evidence strongly suggests that the benefits of vaccination outweigh the risks of adverse effects and disease flares. Herein, we report the protocol of the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study, an ongoing international collaborative study involving 29 countries and over 110 investigators