Bosa Luca, Di Chiara Costanza, Gaio Paola, Cosma Chiara, Padoan Andrea, Cozzani Sandra, Perilongo Giorgio, Plebani Mario, Giaquinto Carlo, Donà Daniele, Cananzi Mara
Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child With Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
Pediatric Infectious Diseases, Department of Women's and Children's Health, University Hospital of Padova, Padova, Italy.
Front Pediatr. 2022 Feb 10;10:815857. doi: 10.3389/fped.2022.815857. eCollection 2022.
To date, there's no evidence of an increased risk of SARS-CoV-2 infection or more severe COVID-19 in patients with inflammatory bowel disease (IBD). However, whether COVID-19 alters the clinical course of IBD or whether IBD treatment affects the immunological response to SARS-CoV-2 is still under investigation, especially in children.
To assess the serological response to SARS-CoV-2 in children with IBD, and to evaluate the impact of COVID-19 on the clinical course of IBD.
This prospective study enrolled children (0-18 years) followed-up at the University Hospital of Padova for IBD, who acquired a confirmed SARS-CoV-2 infection between 02.2020 and 02.2021. The anti-SARS-CoV-2 S-RBD IgG titer was evaluated at 3 months after infection and compared to that of a control group of healthy children matched for age, sex, and COVID-19 severity.
Twelve children with IBD ( = 5; median age 14 years) contracted COVID-19 during the study period. 11/12 patients were under immunomodulatory treatment (4/12 steroids; 6/12 azathioprine; 3/12 anti-TNFs; 2 vedolizumab; 1 ustekinumab). SARS-CoV-2 infection remained asymptomatic in 4/12 children and caused mild COVID-19 in the remaining 8. Mean anti-SARS-CoV-2 IgG S-RBD titer was similar between IBD patients and controls (27.3 ± 43.8 vs. 36.8 ± 35.3 kAU/L, = ns). No children experienced IBD flares nor required gastroenterological support during the infection period.
Children with IBD can mount a protective humoral response against SARS-CoV-2, which is comparable to that of their healthy peers regardless of ongoing immunomodulatory treatment. This study also supports the favorable course of PIBD during COVID-19 and vice-versa.
迄今为止，尚无证据表明炎症性肠病（IBD）患者感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险增加或患新型冠状病毒肺炎（COVID-19）病情更严重。然而，COVID-19是否会改变IBD的临床病程，或者IBD治疗是否会影响对SARS-CoV-2的免疫反应仍在研究中，尤其是在儿童中。
评估IBD患儿对SARS-CoV-2的血清学反应，并评估COVID-19对IBD临床病程的影响。
这项前瞻性研究纳入了在帕多瓦大学医院接受IBD随访的0至18岁儿童，他们在2020年2月至2021年2月期间确诊感染了SARS-CoV-2。在感染后3个月评估抗SARS-CoV-2 S-RBD IgG滴度，并与年龄、性别和COVID-19严重程度相匹配的健康儿童对照组进行比较。
在研究期间，12名IBD患儿（5名男性；中位年龄14岁）感染了COVID-19。11/12例患者正在接受免疫调节治疗（4/12例使用类固醇；6/12例使用硫唑嘌呤；3/12例使用抗肿瘤坏死因子；2例使用维多珠单抗；1例使用乌司奴单抗）。12名儿童中有4名感染SARS-CoV-2后无症状，其余8名儿童患轻度COVID-19。IBD患者和对照组的平均抗SARS-CoV-2 IgG S-RBD滴度相似（27.3±43.8 vs. 36.8±35.3 kAU/L，P=无显著性差异）。在感染期间，没有儿童出现IBD发作，也不需要胃肠病学支持。
IBD患儿能够对SARS-CoV-2产生保护性体液反应，无论是否正在进行免疫调节治疗，这种反应与健康同龄人相当。本研究还支持了IBD在COVID-19期间的良好病程，反之亦然。
