ArticleBMC infectious diseases2025
Risk factors of COVID-19 breakthrough infection: a case-control test-negative design study.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
backgroundWe aimed to identify risk factors for breakthrough SARS-CoV-2 infection after at least one dose of any COVID-19 vaccine.
methodsThis is a case-control test-negative design study in hospitalized patients with a severe acute respiratory infection, at least one dose of any COVID-19 vaccine and a PCR-test for SARS-CoV-2/COVID-19 performed between 1 November 2021 and 28 June 2022. Cases and controls were matched by age and date of test. A logistic regression model with adjusted odds ratios was performed to determine factors related to breakthrough infection.
resultsWe analyzed 1,340 breakthrough SARS-CoV-2 infections matched with 4,016 controls. After adjustment, the odds of a breakthrough infection were 64% higher in patients whose last vaccine dose was administered more than 6 months before hospitalization compared to those vaccinated within the previous 6 months (aOR 1.64; CI 95% 1.42-1.88). Moreover, immunosuppression was statistically associated with breakthrough infection (aOR 2.04; CI 95%, 1.58-2.62). DISCUSSION: The probability of breakthrough SARS-CoV-2 infection was significantly higher in hospitalized patients who had received their last vaccine dose more than six months before hospitalization; while immunosuppression was the most important risk factor for breakthrough infection.
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