ABSTRACT
We thank Dr Mungmunpuntipantip and colleague for their interest and thoughtful comments on our publication. The authors have highlighted several important considerations for the impact of SARS-CoV-2 vaccination in inflammatory bowel disease (IBD) patients with different biological agents. We fully agree with the author's point of view, and we also point out the limitations in our meta-analysis.
ABSTRACT
BACKGROUND: There are concerns regarding the effect of biological agents on SARS-CoV-2 vaccination in patients with inflammatory bowel disease (IBD). A systematic review and meta-analysis was performed about the serological responses, breakthrough infections and clinical relapse of IBD patients treated with biological agents following SARS-CoV-2 vaccination. METHODS: Electronic databases were searched to identify relevant studies. Primary outcomes were the pooled seroconversion rates, breakthrough infection rates and clinical relapse rates after SARS-CoV-2 vaccination in IBD patients treated with biological agents. Secondary outcomes were the comparison of seroconversion rates, breakthrough infection rates and clinical relapse rates in IBD patients treated with biological agents and control cohort after SARS-CoV-2 vaccination. RESULTS: Thirty-five studies were included in this meta-analysis. A high percentage of seroconversion (96.6%, 99% and 99.2%) was achieved in IBD patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab after SARS-CoV-2 vaccination, respectively. The pooled breakthrough infection rate was 2.5% and 3.9% in IBD patients treated with anti-TNF-α therapy and vedolizumab, respectively. The breakthrough infection rate in IBD patients treated with anti-TNF-α therapy was significantly lower than control cohort (RR 0.178, 95% CI 0.084-0.378). The pooled clinical relapse rate in IBD patients treated with anti-TNF-α therapy, vedolizumab and ustekinumab was 6.9%, 5.4% and 5.3%, respectively. CONCLUSION: The overall seroconversion rate after SARS-CoV-2 vaccination in IBD patients treated with biological agents is high. The overall breakthrough infection rate and clinical relapse rate in IBD patients treated with biological agents were low.
ABSTRACT
In the digital age, electronic health literacy (eHealth literacy) of community-dwelling older people plays a potentially important role in their health behaviors which are critical for health outcomes. Researchers have documented that self-efficacy and self-care ability are related to this relationship. This study aimed to assess the relationship between eHealth literacy and health promotion behaviors among older people living in communities and explore the chain mediating role of self-efficacy and self-care ability. For this cross-sectional study, we used data from 425 older adults at 3 communities in Qingdao, Shandong Province in Northeastern China, from June to September 2021. Path analysis using the structural equation model was performed. We found that eHealth literacy was significantly associated with health promotion behaviors in older people. Additionally, eHealth literacy indirectly affected health promotion behaviors through self-efficacy and self-care ability, respectively. In addition, the chain mediation effect was identified in the relationship of eHealth literacy and health promotion behaviors: eHealth literacyâ self-efficacyâ self-care abilityâ health promotion behaviors. These findings offer promising directions for developing interventions to modify older adults' health behaviors through enhancing their eHealth literacy. These interventions should integrate components that target improving the self-efficacy and self-care ability of older people.