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

Abstract

Background The information on seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among patients with inflammatory bowel disease (IBD) and its comparison to healthy controls is sparse. We compared the seroprevalence rates in patients with IBD and healthy controls (HCs). Methods Patients with IBD and HCs (contact of patients) underwent SARS-CoV-2 antibody testing (chemiluminescent immunoassay: Siemens kit IgG against antigen-S1RBD) between July 2020 and April 2021. Information on demography, disease characteristics, drug history and past history of SARS-CoV-2 infection were noted. Patients on 5-aminosalicylic acid or no treatment were considered not on immunosuppressants and those who had received steroids, thiopurines or methotrexate within six months of inclusion were considered being on immunosuppressants. Results A total of 235 patients (51.9%, males; mean age, 38.7 ± 12.4 years; median disease duration, 60 months [interquartile range, IQR: 36–120]) (ulcerative colitis [UC]: 69.4%, Crohn’s disease [CD]: 28.9%, IBD unclassified [IBDU]: 1.7%) and 73 HCs (mean age, 39.6 ± 10.9 years, 80% males) were enrolled. Of the 235 patients, 128 (54.5%) patients were on immunosuppressants and 107 (45.5%) were not on immunosuppressants. Seventy-four (31.5%) patients were seropositive, of which two (0.9%) had previous history of SARS-CoV-2 infection and none received coronavirus disease-19 (COVID-19) vaccine. Seroprevalence between IBD patients and HCs (32% vs. 27%, p > 0.05) and between patients with and without immunosuppressants (28.1% vs. 36%, p > 0.05) was similar. Age, gender, disease type, duration and activity in the last six months; and medication use were similar between patients with positive and negative serology. There was a progressive increase in seroprevalence from July 2020 to April 2021. Conclusion Up to 1/3rd of patients with IBD were seropositive for immunoglobulin G (IgG) SARS-Cov-2 antibody indicating high seroprevalence in patients with IBD from Northern India. Supplementary Information The online version contains supplementary material available at 10.1007/s12664-022-01310-y.

Association Between Inflammatory Bowel Disease and Viral Infections

“…Patients with and without immunosuppressants had similar seroprevalence (32% vs. 27%, p > 0.05) and between patients with and without IBD (28.1% vs. 36%, p > 0.05). Indicating a high seroprevalence in patients with IBD from Northern India, up to 1/3 of IBD patients were seropositive for immunoglobulin G (IgG) SARS-Cov-2 antibodies [35]. In other investigations, researchers found that patients with IBD treated with the anti-TNF drug infliximab, which was linked to an increased risk of SARS-CoV-2 infection, had vaccine-induced antibody responses that were less robust and lasting than patients treated with the anti-integrin drug vedolizumab, which has a gut-specific mode of action and does not result in systemic immunosuppression.…”