Abstract

Crohn’s disease and ulcerative colitis are chronic inflammatory bowel diseases (IBDs). Immunosuppressive medication is the main therapeutic approach to reducing inflammation of the gastrointestinal tract. Immunocompromised patients are more vulnerable to severe courses of illness after infection with common pathogens. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the pathogen of the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 leads to acute respiratory distress syndrome (ARDS) following severe pulmonal damage in a significant number of cases. The worldwide circulation of SARS-CoV-2 has led to major concerns about the management of IBD patients during the pandemic, as these patients are expected to be at greater risk of complications because of their underlying altered immunological condition and immunosuppressive therapies. Vaccination against SARS-CoV-2 is considered the main approach in containing the pandemic. Today, several vaccines have been shown to be highly effective in the prevention of SARS-CoV-2 infection and severe disease course in subjects without underlying conditions in respective registration studies. Patients with underlying conditions such as IBD and/or immunosuppressive therapies were not included in the registration studies, so little is known about effectiveness and safety of SARS-CoV-2 vaccination in immunocompromised IBD patients. This review provides an overview of the recent knowledge about vaccine response in IBD patients after vaccination against SARS-CoV-2.

Highlights

  • Crohn’s disease (CD) and ulcerative colitis (UC) are chronic remittent inflammatory bowel diseases (IBDs)

  • This review offers an overview about current knowledge regarding vaccine responses in IBD patients after vaccination against SARS-CoV-2

  • The effectiveness of vaccination against infection with SARS-CoV-2 has not been exOnly minimal data are available regarding the safety of SARS-CoV-2 vaccination amined prospectively, but Khan et al retrospectively analyzed 14.679 IBD patients in a in immunocompromised IBD patients

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Summary

Introduction

Crohn’s disease (CD) and ulcerative colitis (UC) are chronic remittent inflammatory bowel diseases (IBDs). Glucocorticoid dexamethasone and the interleukin-6 antagonist tocilizumab were shown to significantly reduce hyperinflammation and mortality in severely and critically ill COVID-19 patients [9,10,11]. Despite these therapies, mortality is still high, especially in older patients or patients with known medical conditions such as chronic heart, renal, or lung disease and in patients undergoing immunosuppressive or cancer therapies [12,13]. Several vaccines have been approved for application in humans and have been shown to be highly effective in the prevention of SARS-CoV-2 infection and severe disease course in subjects without underlying conditions in respective registration studies. This review offers an overview about current knowledge regarding vaccine responses in IBD patients after vaccination against SARS-CoV-2

Methods
SARS-CoV-2 Vaccines
Immunological Response to SARS-CoV-2 Vaccines in IBD Patients
Results
Meta-Analysis of Seroconversion Rates in IBD Patients
Effectiveness of SARS-CoV-2 Vaccination in IBD Patients
Safety of SARS-CoV-2 Vaccination in IBD Patients
Conclusions
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