Long-Term Effectiveness and Durability of COVID-19 Vaccination Among Patients With Inflammatory Bowel Disease

被引：5

作者：

Brenner, Erica J. ^{[1
,2
]}

Weaver, Kimberly N. ^{[3
]}

Zhang, Xian ^{[1
,2
]}

Kastl, Arthur J. ^{[4
]}

Strople, Jennifer A. ^{[5
]}

Adler, Jeremy ^{[6
]}

Dubinsky, Marla C. ^{[7
]}

Bousvaros, Athos ^{[8
]}

Watkins, Runa ^{[9
]}

Dai, Xiangfeng ^{[2
]}

Chen, Wenli ^{[2
]}

Cross, Raymond K. ^{[10
]}

Higgins, Peter D. R. ^{[11
]}

Ungaro, Ryan C. ^{[12
]}

Bewtra, Meenakshi ^{[13
]}

Bellaguarda, Emanuelle A. ^{[14
]}

Farraye, Francis A. ^{[15
]}

Chun, Kelly Y. ^{[16
]}

Zikry, Michael ^{[16
]}

Bastidas, Monique ^{[16
]}

Firestine, Ann ^{[1
]}

Craig, Riley G. ^{[17
,18
]}

Boccieri, Margie E. ^{[1
,2
]}

Long, Millie D. ^{[17
,18
]}

Kappelman, Michael D. ^{[1
,2
]}

机构：

[1] Univ North Carolina Chapel Hill, Dept Pediat, Div Pediat Gastroenterol, Chapel Hill, NC USA

[2] Univ North Carolina Chapel Hill, Ctr Gastrointestinal Biol & Dis, Chapel Hill, NC USA

[3] Allegheny Hlth Network, Div Gastroenterol Hepatol & Nutr, Pittsburgh, PA USA

[4] Univ Penn, Childrens Hosp Philadelphia, Perelman Sch Med, Div Gastroenterol, Philadelphia, PA USA

[5] Northwestern Univ, Ann & Robert H Lurie Childrens Hosp Chicago, Div Pediat Gastroenterol Hepatol & Nutr, Dept Pediat,Feinberg Sch Med, Chicago, IL USA

[6] Univ Michigan, Susan B Meister Child Hlth Evaluat & Res Ctr, Dept Pediat, Ann Arbor, MI USA

[7] Icahn Sch Med Mt Sinai, Dept Pediat, Dr Henry D Janowitz Div Gastroenterol, New York, NY USA

[8] Harvard Med Sch, Boston Childrens Hosp, Dept Pediat, Boston, MA USA

[9] Univ Maryland, Sch Med, Div Pediat Gastroenterol & Nutr, Baltimore, MD 21201 USA

[10] Univ Maryland, Sch Med, Div Gastroenterol & Hepatol, Baltimore, MD 21201 USA

[11] Univ Michigan, Div Gastroenterol & Hepatol, Ann Arbor, MI USA

[12] Icahn Sch Med Mt Sinai, Dept Med, Dr Henry D Janowitz Div Gastroenterol, New York, NY USA

[13] Univ Penn, Dept Biostat Epidemiol & Informat, Div Gastroenterol, Philadelphia, PA USA

[14] Northwestern Univ, Div Gastroenterol & Hepatol, Chicago, IL USA

[15] Mayo Clin, Div Gastroenterol & Hepatol, Jacksonville, FL USA

[16] LabCorp, Res & Dev, Calabasas, CA USA

[17] Univ North Carolina Chapel Hill, Dept Med, Div Gastroenterol & Hepatol, Chapel Hill, NC USA

[18] Univ North Carolina Chapel Hill, Multidisciplinary Ctr Inflammatory Bowel Dis, Chapel Hill, NC USA

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2024年 / 22卷 / 07期

基金：

美国国家卫生研究院;

关键词：

COVID-19; Crohn's Disease; Ulcerative Colitis; Vaccination; MEDICATIONS; INFLIXIMAB; VARIANTS;

D O I：

10.1016/j.cgh.2024.02.001

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BACKGROUND AND AIMS: COVID-19 vaccination prevents severe disease in most patients with inflammatory bowel disease (IBD), but immunosuppressive medications can blunt serologic response. We followed adults with IBD for >1 year post-COVID-19 vaccination to describe factors associated with SARS-CoV-2 infection after vaccination, evaluate for a protective SARS-CoV-2 antibody level, characterize SARS-CoV-2 antibody persistence, and identify factors associated with humoral immune response durability. METHODS: Using a prospective cohort of COVID-19 immunized adults with IBD, we analyzed factors associated with SARS-CoV-2 infection after vaccination. We evaluated for an association between SARS-CoV-2 antibody level 12 weeks postvaccination and subsequent SARS-CoV-2 infection and assessed for a threshold of protection using receiver-operating characteristic curve analysis. We then conducted a separate analysis evaluating factors associated with persistence of SARS-CoV-2 antibodies 52 weeks postimmunization. RESULTS: Almost half (43%) of 1869 participants developed COVID-19 after vaccination, but most infections were mild, and <1% required hospitalization. Older age and corticosteroid use were associated with a decreased risk of SARS-CoV-2 infection postvaccination (50-59 years of age vs 18-29 years of age: adjusted hazard ratio, 0.57; 95% confidence interval, 0.44-0.74; steroid users vs nonusers: adjusted hazard ratio, 0.58; 95% confidence interval, 0.39-0.87). Most (98%) participants had detectable antibody levels at 52 weeks postvaccination. Antibody levels at 12 weeks and number of vaccine doses were positively associated with higher antibody levels at 52 weeks, while anti-tumor necrosis factor a therapy was negatively associated. CONCLUSIONS: COVID-19 vaccination generates an effective and durable protective response for the vast majority of adults with IBD, including vulnerable populations such as corticosteroid users and older individuals. Patients with IBD benefit from COVID-19 booster vaccination.

引用

页码：1475 / 1486

页数：12

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