Similar risk of infection with SARS-CoV-2 in immunocompromised and immunocompetent patients with inflammatory bowel disease and healthy controls

ABSTRACT

Background: The information on seroprevalence rates of COVID-19 infection among patients with inflammatory bowel disease (IBD) and its comparison to healthy controls is sparse. We compared the seroprevalence rates in immunocompromised and immunocompetent IBD patients and healthy controls. Methods: Patients with IBD under follow-up at the IBD clinic, All India Institute of Medical Sciences, New Delhi, were included. After obtaining informed consent, patients underwent SARS-CoV-2 antibody testing (chemiluminescent immunoassay Seimens kit IgG against antigen S1RBD) and information on demography, drug history, past history of COVID infection and vaccination status were noted. Patients with IBD on 5-aminosalicylic acid or not on any treatment were considered immunocompetent and those who had received steroids, thiopurines or methotrexate within 6 months of sample collection were considered immunocompromised. Results: 235 patients (51.9%-males;mean age at enrolment- 38.7±12.4 years;median disease duration-60 months [IQR36- 120]) (UC-69.4%, CD-28.9%, IBDU-1.7%) and 73 healthy controls (HCs- mean age-39.6± 10.9 years, 79% males) were enrolled from July 2020 - April 2021 (Table1). 128 (54.5%) patients were immunocompromised and 107 were immunocompetent (treatment details 5 ASA-72.3%, steroids-15.3%, Thiopurines-40%, methotrexate-2.6%). Seventy-four (31.5%) patients were positive for IgG antibody against SARS CoV2, 2 patients (0.9%) had previous history of COVID infection and none received COVID vaccine. Seroprevalence rates between immunocompromised and immunocompetent patients with IBD and healthy controls was similar (28.1% vs 36% vs 28%, p>0.05) (Figure1). Demographic and disease characteristics such as age, gender, disease type, disease activity in last 6 months, disease duration and medication use was similar between patients with positive and negative serology (Table2). There was progressive increase in seroprevalence from July 2020 to April 2021 Conclusion: Upto 1/3rd patients with IBD were seropositive for IgG SARS Cov2 antibody indicating asymptomatic COVID-19 infection. The seroprevalence was similar to healthy controls and was not different between immunocompromised and immunocompetent patients with IBD.