P444 COVID-19 risk factors, infection course and vaccination among patients with inflammatory bowel disease based on a Hungarian cohort
Farkas, K.(1);Matuz, M.(2);Kata, D.(3);Földesi, I.(3);Resál, T.(1);Bacsur, P.(1);Szántó, K.(1);Kolarovszki-Erdei, D.(1);Rutka, M.(1);Fábián, A.(1);Bor, R.(1);Szepes, Z.(1);Sarlós, P.(4);Miheller, P.(5);Zacháry, A.(6);Molnár, T.(1);
(1)University of Szeged, Department of Medicine- Szent-Györgyi Albert Medical School, Szeged, Hungary;(2)University of Szeged, Department of Clinical Pharmacy- Faculty of Pharmacy- University of Szeged- Szeged- Hungary, Szeged, Hungary;(3)University of Szeged, Department of Laboratory Medicine, Szeged, Hungary;(4)University of Pécs, Gastroenterology Unit- 1st Department of Medicine, Pécs, Hungary;(5)Semmelweis University, Department of Surgery and Interventional Gastroenterology, Budapest, Hungary;(6)Hungarian Association of Crohn's Colitis, Hungarian Association of Crohn's Colitis, Budapest, Hungary;
Background
Inflammatory bowel disease potentially elevates the risk of infections, furthermore, disease activity and medical treatment(s) can increase the risk as well. However, both international data and recent studies do not confirm these preliminary conceptions regarding the SARS-CoV-2 infection. In addition, a number of studies have reported that less antibodies are produced against the virus in IBD patients. In January 2021, the vaccination campaign has begun in Hungary as well, however, questions have been raised about the effectiveness and safety of the vaccine.
Methods
In this multicentre study, we assessed the prevalence and risk factors of COVID-19 infection, the willingness to receive COVID-19 vaccine and the efficacy of vaccination among IBD patients receiving biological therapy, based on a cross-sectional questionnaire-based study. To assess safety and antibody response to COVID-19 vaccines, we conducted a prospective study in the same Hungarian IBD centers. IgG antibody was quantified to SARS-CoV-2 spike protein and nucleocapsid 1 week before and after the first vaccine and 4 and 8 weeks after the second vaccinane, respectively.
Results
472 patients were enrolled in the first part of our study. SARS-CoV-2 infection was confirmed in 16.9% of patients. Wearing gloves and masks were found to be effective in preventing infection (p=0.02; p=0.005), avoidance of communal areas had no effect on infection rates. Male sex increased the risk (p=0.008) of viral infection. Based on subjective complaints, UC patients had a worse disease course (p=0.002). Biological therapies did not increase the risk of infections. Patients vaccinated with mRNA vaccine had a significantly higher spike protein antibody titer one month after the second vaccination (p=0.004) compared to other vaccine types (Sinopharm©, Sputnik V©, Astra Zeneca©). Seropositivity was detected in 98% of patients. Sinopharm© vaccination triggered the lowest number of side effect (p<0.001). SARS-CoV-2 infection induced relapses more frequently than vaccinations.
Conclusion
Face mask was the most effective preventive tool. The risk of infection was not increased by biological therapy, therefore therapy discontinuation is not justified. Almost every vaccinated patient developed seropositivity two month after vaccination independently from the type of the vaccine, however, spike protein antibody was significantly higher following mRNA vaccinations.