COVID-19 and COVID-19 Vaccinations Lead to Serological Responses in Patients with Inflammatory Bowel Diseases Independent of the Type of Immunomodulatory Medication.

Background/

Objectives

The COVID-19 pandemic and the development of vaccines provided the opportunity to monitor disease prevalence and outcomes, vaccinations, their side effects and serological responses in patients with inflammatory bowel disease (IBD).

Methods

IBD patients of the outpatient clinic at the University Hospital Heidelberg who completed at least one questionnaire on COVID-19 and related vaccinations from July 2021 to August 2022 were included. Spike-IgG antibody titres were determined. Friedman tests, Wilcoxon signed-rank tests and Kruskal-Wallis tests were used for comparisons. The influence of IBD therapy was analysed using linear models with mixed effects.

Results

The cohort included 520 patients (269 females, mean age = 45.3 years, 60.6% with Crohn's disease, 35.4% with ulcerative colitis, and 4.0% with unclassified IBD). Four hundred eighty patients (92.3%) received at least one COVID-19 vaccination, and 154 patients (29.6%) were infected by SARS-CoV-2. Among all of them, 94.4% achieved seroconversion. Triple-vaccinated patients with additional SARS-CoV-2 infection developed the highest serological responses (χ2 = 16.51, p < 0.001, df = 3). An antibody decay over time was observed after the second (p < 0.001) and third vaccinations (p < 0.001). Regarding individual IBD medications, no differences in mean titres were found after two (χ2 = 6.60, p = 0.36, df = 6) versus three vaccinations (χ2 = 4.97, p = 0.42, df = 5). Linear models with mixed effects revealed no influence of IBD therapies on serological responses.

Conclusions

The highest serological responses were observed in IBD patients after three vaccinations plus SARS-CoV-2 infection without significant differences between IBD therapies.