A Seroprevalence Study of Anti-SARS-CoV-2 Antibodies in Patients with Inflammatory Bowel Disease during the Second Wave of the COVID-19 Pandemic in Italy

Abstract

Background and Objectives: Studies have shown a lower prevalence of anti-SARS-CoV-2 antibodies in patients with inflammatory bowel disease (IBD), including amongst those receiving biological therapy. Aims were to determine the seroprevalence of anti-SARS-CoV-2 antibodies in IBD patients and to assess any association between seropositivity and IBD characteristics. Materials and Methods: Serum from adult IBD patients was prospectively collected between December 2020 and January 2021 and analyzed for anti-SARS-CoV-2 antibodies. Information about IBD characteristics and SARS-CoV-2 exposure risk factors was collected and analyzed. Serum from non-IBD healthcare workers formed the control group. Results: 311 IBD patients on biologics and 75 on mesalazine were enrolled. Ulcerative colitis (UC) extension (p < 0.001), Crohn’s disease (CD) phenotype (p = 0.009) and use of concomitant corticosteroids (p < 0.001) were significantly different between the two IBD groups. Overall seroprevalence among IBD patients was 10.4%. The control group showed a prevalence of 13.0%, not significantly different to that of IBD patients (p = 0.145). Only a close contact with SARS-CoV-2 positive individuals and the use of non-FFP2 masks were independently associated with a higher likelihood of seropositivity amongst IBD patients. Conclusion: In IBD patients, the prevalence of anti-SARS-CoV-2 antibodies is not determined by their ongoing treatment. Disease-related characteristics are not associated with a greater risk of antibody seropositivity.

High seroprevalence against SARS-CoV-2 in non-vaccinated patients with inflammatory bowel disease from Northern India

“…The seroprevalence was similar between patients with IBD and healthy controls and the rates were independent of any immunosuppressant drug intake, including steroids, thiopurines or methotrexate. These results are similar to other studies in patients with IBD, which have reported prevalence rates similar to their respective populations, indicating that disease and immunosuppression did not increase the seroprevalence rates when compared to healthy population [ 10 – 21 ]. However, our results were contradictory to the results of the study by Lodyga et al, where they showed that patients of IBD had higher seroprevalence rates when compared to a healthy population [ 17 ].…”

“…These rates are much higher when compared with studies in patients with IBD conducted in other parts of the world during the same time period. Most of these studies have been conducted in Western Europe (UK, Italy, Germany, Poland) and the USA (Table 3 ) and the seroprevalence rates in these studies varied from 0.5% to 21% [ 10 – 21 ]. The probable reason for the high seroprevalence rates in our study compared to other global studies might be high infection rates in the community during the same time period.…”

“…Thus, serological positivity to SARS-CoV-2 antibody determines the previous infection to SARS-CoV-2 irrespective of symptoms [ 9 ]. Multiple studies from different populations reported seropositivity rates in patients with IBD range from 0.5% to 21% [ 10 – 21 ]. However, the data of seroprevalence rates from Asian population, where the IBD disease burden is high, is lacking.…”

The risk of COVID-19 in IBD patients is increased by urban living and is not influenced by disease activity or intravenous biologics

“…Regarding the association of the occurrence of COVID-19 with socio-demographic factors, a single-center prospective Italian study including 386 patients with IBD also demonstrated that the prevalence of anti-SARS-CoV-2 antibodies was determined neither by the ongoing IBD-specific treatment nor disease-related characteristics. Only a close contact with SARS-CoV-2 positive individuals and the use of non-FFP2 masks were independently associated with a higher likelihood of seropositivity amongst patients with IBD, supporting the data of our study in which sanitary barrier measures look more important than clinical IBD characteristics ( 42 ).…”