ABSTRACT
Introduction: SARS-CoV-2 infection may lead to the development of the novel coronavirus disease (COVID-19). Scarce data is available regarding safety and efficacy of SARS-CoV-2 vaccination in IBD patients, which may present differences between subgroups. Lower immunological response could require an additional booster injection. Aims & Methods: Prospective study including adult patients with IBD after complete vaccination against SARS-COV-2 infection with BioNTech vaccine. Patients with previous SARS-COV-2 infection were excluded. A control group with healthy individuals matched for age and sex was also analyzed. Blood samples were collected 30 days after complete vaccination to quantify IgG antibody titers against SARS-CoV-2 in both groups. Result(s): Final sample included 81 IBD and 32 non-IBD patients, 55(48.7%) of them females, with a mean age of 40.2+/-13.0 years. From IBD patients, 58(71.6%) had CD and 23(28.4%) UC. IBD patients had significantly lower median anti-SARS-COV-2 IgG levels when compared to the control group (6479, IQR-10053 vs 13061, IQR-15539 AU/mL;p=0.003). Regarding IBD medication, significant lower levels of SARS-COV-2 IgG antibodies when compared to controls where observed in patients under thiopurines (5423, IQR-10260 AU/mL;p=0.011);methotrexate (834, IQR-4155 AU/mL;p=0.002);infliximab (5294, IQR-10392 AU/mL;p=0.001);and corticosteroids (548, IQR-n/a AU/mL;p=0.001). The incidence of SARS-CoV-2 infection after vaccination was also significantly higher in each of these treatments - healthy controls 25% vs thiopurines 50% (p=0.025), infliximab 43.8% (p=0.048), methotrexate 75% (p=0.041) and corticosteroids 100% (p=0.027). Conclusion(s): IBD patients under Immunomodulators, infliximab and corticosteroid treatment presented significantly lower anti-SARS-COV-2 IgG levels 30 days following complete vaccination when compared to healthy controls. These findings could support the benefit of an additional booster injection in this population.
ABSTRACT
Background: The severe acute respiratory syndrome coronavirus, 2 (SARS-COV-2) infection may lead to the development of the novel coronavirus disease, 2019 (COVID-19). Currently, little to no data is available regarding safety and efficacy of SARS-COV-2 vaccination in Inflammatory Bowel Disease (IBD) patients, which may present differences between subgroups, as these patients may exhibit impaired innate and adaptive immune system responses. Lower immunological response could, in this specific population, require an additional booster injection. Methods: We conducted a prospective study including adult patients with Crohn's disease (CD) and Ulcerative Colitis (UC) who have undergone complete vaccination against SARS-COV-2 infection with BioNTech® vaccine. Patients with previous SARS-COV-2 infection were excluded. Medical data regarding age, sex, IBD classification and current medication for IBD were collected. A control group with healthy individuals matched for age and sex was also analyzed. Blood samples were collected, 30 days after complete vaccination to quantify IgG antibody titers for SARS-COV-2 in both groups (IBD and non-IBD). Results: Our final sample included, 81 IBD and, 32 non-IBD patients, 55 (48.7%) of them females, with a mean age of, 40.2±13.0 years. From the IBD patients, 58(71.6%) had CD and, 23(28.4%) had UC. IBD patients had significantly lower anti-SARS-COV-2 IgG levels when compared to the control group (8950±9366 vs, 14834±11679 AU/mL;p=0.003). Regarding IBD medication, significant lower levels of SARS-COV-2 IgG antibodies when compared to control patients were found in patients under thiopurines (9074±9779 AU/mL;p=0.011);methotrexate (1987±2568 AU/mL;p=0.002);infliximab (7208±7276 AU/ mL;p=0.001);and corticosteroids (1065±933 AU/mL;p=0.001). Additionally, patients under combined therapy (infliximab plus thiopurines) presented with significantly lower antibodies titers when compared to patients treated with thiopurines in monotherapy (8130±11048 vs, 10563±5680 AU/mL;p=0.039). No significant differences were found in IBD patients under salicylates (10195±7371 AU/mL;p=0.226);adalimumab (15644±21467 AU/mL;p=0.336);vedolizumab (10464±9087 AU/mL;p=0.286) and ustekinumab (11366±10016 AU/mL;p=0.390). Conclusion: IBD patients presented with significantly lower anti- SARS-COV-2 IgG levels, 1 month after complete vaccination against SARS-COV-2 infection compared to healthy controls. Thiopurines, methotrexate, infliximab and corticosteroid treatment were associated with significantly lower antibodies levels. These findings may express the benefit of an additional booster injection in this population.
ABSTRACT
Aims An outbreak of coronavirus disease 19 (COVID-19) has altered the dynamic of endoscopic practices. Many guidelines, questionnaires have been published addressing service resumption during the pandemic. Curious about the situation indifferent endoscopic units across the globe, the study was designed to evaluate different aspects of practice resumptionworldwide and their adherence to guidelines. Methods An online questionnaire was created and distributed by national/regional representatives and societies. Redcapplatform was used as the interface;afterwards, Microsoft Excel 2016 and Prism 5 were utilized for data analysis. Results From a total of 307 responses from 47 countries/regions was collected, 290 valid answers were analyzed. Almosthalf (47 %) were in post-peak period by August, 2020. Many units were not designated to be COVID-oriented facility. About15.5 % of centers remained unrecovered, mainly in North and South America;those were recovered, training was still withheld significantly. Nevertheless, opened centers kept safety measurements strictly. Patient load was decreased by 37 %,but waiting list was increased 0-25 %. Among many surveillance methods, body temperature, PCR and chest CT were themost common. 74.8 % increased post-procedural disinfection time and 68.2 % increase in per-case inspection were noted.PPE usage was implemented highly and shortage of these posed as one of the resumption barriers. Post-procedural patientsurveillance was not reinforced. Conclusions The study represented real-time global endoscopic service's adaptation to COVID-19 pandemic. Previouslypublished barriers upon practice resumption remained. Despite Delphi consensus' emphasis on post-procedural surveillance, application was not widely reinforced, raising concerns in disease control.