Published online Mar 16, 2022. doi: 10.4253/wjge.v14.i3.153
Peer-review started: October 11, 2021
First decision: December 3, 2021
Revised: December 14, 2021
Accepted: February 16, 2022
Article in press: February 16, 2022
Published online: March 16, 2022
Guidelines recommend to cease inflammatory bowel disease (IBD) biologic therapy during coronavirus disease 2019 (COVID-19).
To investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody positivity in an IBD cohort, COVID-19 disease severity and to evaluate the correlation with clinical/therapeutic variables.
Prospective observational cohort study. IBD patients were tested for SARS-CoV-2 IgG. Data on COVID-19 disease, demographics/therapeutics and clinical features of the IBD population were collected. IgG ≥ 7 was set for SARS-CoV-2 antibody positivity. Throat swab was performed in cases of IgG positivity. Correlations between antibody positivity or COVID-19 symptoms and therapeutic/clinical data were assessed.
In total, 103 IBD patients were enrolled. Among them, 18.4% had IgG ≥ 7. Multivariate analysis of antibody positivity correlated only with IBD treatment. For IgG ≥ 7, the odds ratio was 1.44 and 0.16 for azathioprine and mesalazine, respectively, vs biologic drugs (P = 0.0157 between them). COVID-19 related symptoms were reported in 63% of patients with IgG positivity. All but one patient with COVID-19 symptoms did not require ceasing IBD treatment or hospitalization. IBD treatment and body mass index correlated with COVID-19 disease development with symptoms.
The IBD population does not have a higher risk of severe COVID-19. The relative risk of having SARS-CoV-2 antibodies and symptoms was higher for patients taking azathioprine, then biologic therapy and lastly mesalazine. None of the patients under biologic therapy developed severe COVID-19.
Core Tip: Guidelines recommend ceasing inflammatory bowel disease (IBD) biologic therapy during coronavirus disease 2019 (COVID-19). IBD patients were prospectively tested for severe acute respiratory syndrome coronavirus 2 IgG. In total, 103 IBD patients were enrolled. We found that 18.4% had IgG positivity, and 63% developed COVID-19 disease with symptoms. However, all but one patient with symptoms did not require ceasing IBD treatment no hospitalization. None of the patients under biologic therapy developed severe COVID-19. Therefore, the IBD population does not seem to have a high risk of severe COVID-19, particularly if under biological treatment or mesalazine.