Abstract
Severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic. Vaccination is considered the core approach to containing the pandemic. There is currently insufficient evidence on the efficacy of these vaccines in immunosuppressed inflammatory bowel disease (IBD) patients. The aim of this study was to investigate the humoral response in immunosuppressed IBD patients after COVID-19 mRNA vaccination. In this prospective study, IgG antibody levels (AB) against the SARS-CoV-2 receptor-binding domain (spike-protein) were quantitatively determined. For assessing the potential neutralizing capacity, a SARS-CoV-2 surrogate neutralization test (sVNT) was employed in IBD patients (n = 95) and healthy controls (n = 38). Sera were examined prior to the first/second vaccination and 3/6 months after second vaccination. Patients showed lower sVNT (%) and IgG-S (AU/mL) AB both before the second vaccination (sVNT p < 0.001; AB p < 0.001) and 3 (sVNT p = 0.002; AB p = 0.001) and 6 months (sVNT p = 0.062; AB p = 0.061) after the second vaccination. Although seroconversion rates (sVNT, IgG-S) did not differ between the two groups 3 months after second vaccination, a significant difference was seen 6 months after second vaccination (sVNT p = 0.045). Before and three months after the second vaccination, patients treated with anti-tumor necrosis factor (TNF) agents showed significantly lower AB than healthy subjects. In conclusion, an early booster shot vaccination should be discussed for IBD patients on anti-TNF therapy.
Highlights
Severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic [1]
All patients who were not vaccinated with mRNA vaccines or who were not inoculated with the same vaccine on both occasions were excluded
There were no differences in body mass index (BMI) between inflammatory bowel disease (IBD) patients and healthy controls (p = 0.171)
Summary
Severe acute respiratory syndrome coronovirus-2 (SARS-CoV-2) is the cause of the coronavirus disease 2019 (COVID-19) pandemic [1]. In remission induction and maintenance therapy of both diseases, immunosuppressive drugs are generally used to reduce inflammatory activity in the gastrointestinal tract [10,11]. The use of immunosuppressive therapies can lead to serious side-effects, such as opportunistic infections. Patients under immunosuppression have a higher susceptibility to severe disease following infection with common pathogens [12]. The COVID-19 pandemic has raised major concerns about the treatment of IBD patients. Recent studies have indicated the possibility of more severe disease progression in IBD patients due to their altered immunological status and existing immunosuppressive drug therapies [13]. Therapeutic approaches to combat COVID-19 are being developed worldwide; until recently, few therapies have proven effective
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