ABSTRACT
Introduction: Inflammatory bowel disease (IBD) patients use a wide variety of immunosuppressive drugs, including biologics, but their effect on SARS-CoV-2 vaccine antibody levels remains a mystery. Aim: We analysed whether the drugs used in the treatment of IBD patients could affect the concentration of SARS-CoV-2 antibodies. Material and methods: This is a prospective, single-centre evaluation of the persistence of SARS-CoV-2 antibodies after vaccination at various time points: every 2 months throughout the 6th month after the first dose. Results: We included a total of 346 vaccinated IBD patients in the study. A negative correlation between antibody level and time from full vaccination was confirmed for the following types of therapy: infliximab (rho = -0.32, p < 0.001), adalimumab (rho = -0.35, p = 0.025), and vedolizumab (rho = -0.50, p < 0.001). In the case of other, long-term drug administration, a negative correlation between antibody level and time from full vaccination was confirmed for mesalazine (rho = -0.35, p < 0.001), budesonide (rho = -0.58, p = 0.004), systemic glucocorticoids (rho = -0.58, p < 0.001), and azathioprine (rho = -0.44, p < 0.001). Conclusions: Due to the immunosuppressive and biological treatment, IBD patients are exposed to a shorter persistence of SARS-CoV-2 antibodies and require booster doses. The role of gastroenterologists in educating patients about the need to continue SARS-CoV-2 vaccination remains crucial.
ABSTRACT
Introduction: The aim of this study was to investigate the persistence of SARS-CoV-2 neutralizing antibodies (NAbs) one year after contracting COVID-19. Material and methods: The study included 38 patients - 34 men and 4 women - suffering from COVID-19 between March 15 and May 26, 2020. The median age in the group was 31 years, ranging from 22 to 67 years. The levels of neutralizing antibodies were measured at three time-points - baseline, 6 months, and 12 months. The primary endpoint was a post-infection positive result for NAbs (> 15 AU/ml; Liaison SARS-CoV-2 S1/S2 IgG quantitative test) 12 months after infection. Results: The median level of NAbs after 12 months was 26.5 AU/ml. At the end of observation (12 months), 21 of the 38 patients had a NAb level of >15 AU/ml (positive). The median antibody half-life was 5.8 months. Conclusions: A high percentage of the patients maintained positive levels of antibodies 6 and 12 months after COVID-19 infection. The dynamics of the antibody level decline suggests the need for booster vaccination at least once a year.
ABSTRACT
Introduction: Gastrointestinal (GI) symptoms can be considered as a manifestation of coronavirus disease 2019 (COVID-19). Aim: Our study analysed GI symptoms depending on their occurrence, and their possible causes and impact on the course of COVID-19. Material and methods: A retrospective, single-centre assessment of the frequency, risk factors, and impact of GI symptoms in 441 patients with COVID-19. Results: A statistically significant reduction in the length of stay (LOS) (15 days vs. 17 days; p = 0.04), intensive care unit admission (ICU) (16.9% vs. 26.8%; p = 0.02), and need for mechanical ventilation (14.1% vs. 23.4%; p = 0.02) in the group who had experienced GI symptoms before hospitalization was noticed. For comparison, patients who developed GI symptoms during hospitalization had statistically significantly longer LOS (21 days vs. 15 days; p = 0.0001), were more frequently admitted to the ICU (38.1% vs. 18.6%; p = 0.0003), and had a higher need for mechanical ventilation (32.7% vs. 16.2%; p < 0.001). Risk factors for GI symptoms during hospitalization in COVID-19 patients included age, Clostridioides difficile infection, and receiving certain treatment (antibiotics and lopinavir + ritonavir). Conclusions: The GI symptoms that developed before admission to hospital correlated with reduced severity of the course of COVID-19. However, in the group of patients who developed GI symptoms during hospitalization, attention should be paid to concomitant treatment. The use of antibiotics should be limited because they are associated with the deterioration of the course of COVID-19; one of the reasons might be changes in the intestinal microbiome.
ABSTRACT
OBJECTIVE: This study aimed to investigate the efficacy and safety of convalescent plasma (CP) transfusion in a group of high-risk COVID-19 patients. METHODS: This prospective study included 204 patients from a single tertiary-care hospital, hospitalized with COVID-19, of whom 102 were treated with CP administration and standard care (PG) and 102 others who received standard care only (CG). The CG was selected from 336 hospitalized patients using the propensity-score matching (PSM) technique using age, MEWS score, and comorbidities. The primary outcome was mortality rate; secondary outcomes were the requirement of a ventilator, length of ventilator need, length of intensive care unit (ICU) stay, and length of overall hospital confinement. Additionally, parameters predicting death in COVID-19 patients were identified. RESULTS: Findings confirmed a significantly lower mortality rate in the PG versus the CG (13.7% vs. 34.3 %, p = 0.001) and a significant difference in the cumulative incidence of death between the two groups (p < 0.001). CP treatment was associated with lower risk of death (OR = 0.25 CI95 [0.06; 0.91], p = 0.041). There were no significant differences in ICU stay, ventilator time, and hospitalization time between the two groups. CONCLUSIONS: A significantly lower mortality rate was observed in the group of patients treated with CP. Age, presence of cardiac insufficiency, active cancer, a ventilator requirement, and length of hospitalization significantly increased the risk of death in both groups. Our study shows that CP affords better outcomes when administrated in the earlier stage of high-risk COVID-19 disease.
