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1.
Journal of Crohn's & colitis ; 16(Suppl 1):i310-i311, 2022.
Article in English | EuropePMC | ID: covidwho-1999683

ABSTRACT

Background Owing to the COVID-19 pandemic, inflammatory bowel disease (IBD) patients are strongly encouraged to vaccinate against SARS-COVID-19. In fact, the uptake of this vaccine in IBD cohorts has been greater than the general population. The adverse events of this vaccine are predicted to be low. The aim of this study was to assess the percentage of IBD patients who took the COVID-19 vaccine- including booster- and any significant adverse events. Any possible correlation with lifestyle habits, treatment and disease activity was also established. Methods Data was collected prospectively. 200 patients with a histological diagnosis of IBD were randomly recruited through our local database. Data was gathered using electronic case summaries and direct patient contact. Data collected included;diagnosis, type and number of COVID-19 vaccines taken, demographics, lifestyle habits, treatment and any adverse events to the vaccine. Patients were also asked about any concerns regarding this vaccine. Results 187 patients (57.8% male) were recruited. 73.8% of which had Crohn’s disease (CD), 25.7% had Ulcerative colitis (UC) and 0.5% were unclassified. Mean age was 41.96 (SD ±16.56). 37.8% were on Azathioprine/6- Mercaptopurine, 93.5% were on biologicals and 33.2% were on both. 61% had quiescent IBD while 2.1% had severe IBD. 19.7% were current smokers while 15.8% were ex-smokers. 98.9% received at least one COVID-19 vaccine. Table 1 illustrates the type of vaccine administered to IBD patients. 17% of patients were concerned regarding the effectiveness of the vaccine due to IBD treatment. 19.8% of IBD patients believed that the vaccine may trigger a flareup of their disease. 11.8% of patients felt that not enough information was available to make an informed choice. 7.1% of IBD patients had treatment altered in response to the COVID-19 vaccine. Graph 1 shows the percentage of both local and systemic adverse events to 1st, 2nd and 3rd Covid-19 vaccine in IBD patients. Conclusion This study demonstrates that the uptake of COVID-19 vaccine in IBD patients was high. The most commonly report adverse events were pain at the injection site and fever. Increased in temperature at the injection site occurred more frequently with the 3rd dose. A number of patients had a change in their medication in response to at least one the vaccines. Larger studies are needed to decipher whether data can be extrapolated on a larger scale.

2.
Journal of Crohn's & colitis ; 16(Suppl 1):i334-i334, 2022.
Article in English | EuropePMC | ID: covidwho-1999398

ABSTRACT

Background Inflammatory Bowel Disease(IBD) and Irritable Bowel Syndrome(IBS) are gastrointestinal disorders which differ in pathophysiology and management. The use of immunomodulatory drugs brings concerns which increased during the pandemic. Similarly, patients with IBS may have concerns about the effect of infection and vaccine on their wellbeing. The aim of this study was to assess for any differences in swabbing, vaccine uptake, COVID-19 infection, hospitalisation rates and outcomes in patients with IBD on immunomodulatory treatment and patients with IBS. Methods Patients were recruited through the local database (March, 2020 – August, 2021). All IBD patients had a histological diagnosis while IBS patients were diagnosed according to ROME IV criteria. All patients were offered vaccination. Apart from demographic data the following was collected: number of COVID-19 swabs taken, vaccination rates, type of vaccine administered, infection secondary to COVID-19, hospitalization and outcomes. Results Overall, 250 IBD patients (43.6% female) and, 250 patients with IBS (78.4% female) were recruited. The mean patient age in the IBS cohort was, 40.6 years (SD ±, 11.99) whilst the mean patient age in the IBD cohort was, 40.7 years (SD±15.7). Patients with IBD underwent significantly more COVID-19 swab tests (n=759) than patients with IBS (n=615) (p =0.02). Patients with IBD were having the following biological therapy:, 62.8% Infliximab, 24.8% Adalimumab, 10% Vedolizumab and, 2.4% Ustekinumab. There was no significant difference in COVID-19 infection rate between the IBS cohort (8.8%;n=22 patients;, 2 patients not vaccinated) and the IBD cohort (6.4%;n=16 patients;, 3 patients not vaccinated)(p=0.3). The vaccine uptake rate was similar (IBD:, 91.2%, IBS: 90%). Table, 1 demonstrates the type of vaccine administered to both cohorts. In the IBS cohort, 1 patient was admitted to hospital in view of symptomatic hypoxaemia. The patient was treated with oxygen and dexamethasone, but did not require ventilatory support. Within the IBD cohort, 3 patients requiring admission for IBD related treatment, tested positive asymptomatically on pre-admission COVID-19 screening. All had an uneventful outcome.Table 1CohortPfizerAstraZenecaJohnson&JohnsonModernaIBD43%54%1%2%IBS57%31%7%5% Conclusion This study demonstrates that vaccine uptake, Covid-19 infection rates and outcomes were similar in patients with IBS and IBD patients on immunosuppressive therapy. However, IBD patients underwent significantly more swabbing than patients with IBS and this was generally due to patient concern of acquiring Covid-19 while being on immunosuppresive medications. This added psychological burden may further impact patients’ psychological state and thus their quality of life.

3.
Gastroenterology ; 162(7):S-1006, 2022.
Article in English | EMBASE | ID: covidwho-1967393

ABSTRACT

Introduction: Pivotal anti-SARS-CoV-2 vaccines clinical trials did not include patients with immune-mediated conditions such as inflammatory bowel disease (IBD). We aimed to describe the implementation of anti-SARS-CoV-2 vaccines among IBD patients, patients' concerns before vaccination and side-effect profile of the anti-SARS-CoV-2 vaccines using real-world data. Methods: An anonymous web-based self-completed survey was distributed in 36 European countries between June and July 2021. The results of patients' characteristics, concerns, vaccination status and side-effect profile were analysed using descriptive statistics and logistic regression. Results: Among the 3272 IBD patients completing the survey (0.1% of the IBD European population), 79.6% had received at least one dose of anti-SARS-CoV- 2 vaccine, and 71.7% had completed the vaccination process. Most of the patients (70.6%) were vaccinated with the Pfizer-BioNTech (BNT162b2) vaccine. Patients over 60 years old had a significantly higher rate of vaccination (OR 2.98, 95% CI 2.20-4.03, p<0.001). Patients' main concerns before vaccination were the possibility of having worse vaccine-related adverse events due to their IBD (24.6%), having an IBD flare after vaccination (21.1%) and reduced vaccine efficacy due to IBD or associated immunosuppression (17.6%). After the first dose of the vaccine, 72.4% had local symptoms at the injection site and 51.4% had systemic symptoms (5 patients had non-specified thrombosis). Adverse events were less frequent after the second dose of the vaccine and in older patients. When comparing with previous studies from the general population, the IBD patients answering the survey did not seem to have increased side effects (table 1). Only a minority of the patients were hospitalized (0.3%), needed a consultation (3.6%) or had to change IBD therapy (13.4%) after anti- SARS-CoV-2 vaccination. Conclusion: Although IBD patients raised concerns about the safety and efficacy of anti-SARS-CoV-2 vaccines, the implementation of vaccination in those responding to our survey was high and the adverse events were comparable to the general population, with minimal impact on their IBD. (Table Presented)

4.
United European Gastroenterology Journal ; 9(SUPPL 8):386-387, 2021.
Article in English | EMBASE | ID: covidwho-1490989

ABSTRACT

Introduction: There is an ongoing concern over the impact of COVID-19 on IBD patients. A significant proportion of IBD patients are treated with immunosuppressive medications and their effects on COVID-19 susceptibility and outcomes remain of concern to patients and physicians alike. Apart from the clinical outcome, the pandemic may have other psychosocial effects on this vulnerable cohort, such as employment stability. Aims & Methods: The primary aim of this study was to analyze the percentage of patients who tested themselves for COVID-19 and the outcome of those who tested positive. A secondary aim was to assess their employment status. This was a multicentre international study whereby IBD patients (>18 years) in clinical remission over the last year, were asked to answer an anonymous questionnaire. Demographic data, type of IBD, current and previous medication, admissions to hospital, were collected. Exclusion criteria included patients with IBD flares requiring corticosteroids in the previous 12 months. Results: 585 patients (CD: n=325) from 8 European Centres and Israel participated in the study. The mean patient age was 40.1 years (SD+/- 13.1). 21.6% were smokers and 48.5% were non-smokers. The rest were ex-smokers. 44.5% (n=255 ) of patients were tested for Covid-19 and 5.1% (n=13) were positive. The majority were treated at home (92.3%) with only one patient requiring hospital admission. This was a 33-year-old female smoker with UC (E3 disease activity) on anti-TNF therapy. 66.7% of positive cases were on anti-TNF medication and 22.2% were on thiopurines. None of the positive cases were on dual antiTNF/thiopurine therapy. 7.2% of patients had family members who also tested positive for Covid-19. Almost half of all patients (45.2%) had their job affected during the pandemic and this was more prevalent in the UC cohort (P<0.05). 70% of patients switched to remote work from home and 21.4% became unemployed. The average age of patients becoming unemployed was 39.3year (SD+/- 11.9). Conclusion: Nearly half of our cohort (45.2%) were tested for Covid-19. The majority (92.3%) were treated at home, even though two thirds of them were on Anti-TNF medication. Unemployment rates affected 1 in 5 individuals and measures promoting remote work have been taken up wisely by IBD patients. Though the clinical outcomes were excellent, the psychological effects of unemployment may have yet to be considered.

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