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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.
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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.
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BACKGROUND: Inflammatory bowel disease is a chronic recurrent disease, and the treatment goals of inflammatory bowel disease are mainly based on doctors' perspective, but there are some differences between the doctor's perspective and the patient's perspective. The aim of this study is to understand the treatment goals and the related factors from the patients' perspective during the coronavirus disease 2019 pandemic. METHODS: A total of 212 participants were recruited to fill out the questionnaires including clinical characteristics and treatment goals. Eleven treatment goals were measured by a Short-Form 34 questionnaire. Univariate and multivariate regression analyses were used to explore the related factors about these treatment goals. RESULTS: A total of 212 inflammatory bowel disease patients were enrolled in this study. The most concerned treatment goal was the improvement of quality of life (mean score was 8.54), while mean score of ulcerative colitis patients and Crohn's disease patients was 9.10 and 8.45, respectively. We had also found some related factors such as the type of disease, the course of disease, the frequency of hematochezia, and defecation. CONCLUSION: Our survey showed that inflammatory bowel disease patients pay more attention to the improvement of quality of life and few drugs during the coronavirus disease 2019 pandemic. There are some related factors such as the type of disease, the course of dis- ease, the frequency of hematochezia, and defecation. Our results help clinicians understand the patients' treatment goals, which can contribute to better management of inflammatory bowel disease patients.
Assuntos
COVID-19 , Colite Ulcerativa , Doenças Inflamatórias Intestinais , COVID-19/epidemiologia , China/epidemiologia , Doença Crônica , Hemorragia Gastrointestinal , Objetivos , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/terapia , Pandemias , Qualidade de Vida , Autorrelato , Inquéritos e QuestionáriosRESUMO
BACKGROUND: The worldwide outbreak of COVID-19 infected millions of people. Some patients had gastrointestinal (GI) symptoms, abnormal liver function, digestive system disease and liver disease. AIM: To investigate the prevalence of GI symptoms, abnormal liver function, digestive system disease and liver disease in patients with COVID-19 by a systematic review and meta-analysis. METHODS: We searched PubMed, Ovid Embase, Medline, and 2 Chinese databases. Primary outcomes were the prevalence of GI symptoms, abnormal liver function, digestive system disease, and liver disease. Different studies were included in different subset analysis. These outcomes were estimated with proportions, odds ratio, 95% confidence interval (CI) and P-value by Stata SE 15.1. RESULTS: Thirty-one studies involving 4682 patients were included. The most significant GI symptoms were diarrhea (0.08, 95% CI: 0.06-0.11) and anorexia (0.17, 95% CI: 0.06-0.27). The most significant abnormal liver function was increased alanine aminotransferase (ALT) (0.25, 95% CI: 0.16-0.33). A total of 5% of the patients had digestive system disease (95% CI: 0.02-0.08). A total of 3% of the patients had liver disease (95% CI: 0.02-0.05). The prevalence of nausea and vomiting, diarrhea, abnormal liver function, digestive system disease, and liver disease was higher in Wuhan group. The prevalence of diarrhea was higher in non-China group. Patients in severe/intensive care unit group were more likely to have diarrhea, anorexia, abdominal pain increased aspartate aminotransferase, and increased ALT. CONCLUSION: The most significant GI symptoms were anorexia and diarrhea. The most significant abnormal liver function was increased ALT. Severe patients were more likely to have GI symptoms and abnormal liver function.