Department of Systems Medicine, Unit of Gastroenterology, Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy.
Eur Rev Med Pharmacol Sci. 2022 May;26(10):3787-3796. doi: 10.26355/eurrev_202205_28875.
In a prospective study, SARS-CoV-2 IgG seroprevalence was assessed during the second pandemic wave (W2) in a cohort of Inflammatory Bowel Disease (IBD) patients using biologics. The secondary aim was to compare, in the same cohort, the frequency of seropositivity and of COVID-19 during the second vs. the first (W1) wave.
From November 2020 to March 2021, SARS-CoV-2 IgG seropositivity and the prevalence of COVID-19 were assessed in a cohort of IBD patients using biologics already studied at W1.
age ≥ 18 years; diagnosis of IBD; follow-up; written consent.
SARS-CoV-2 vaccination. Risk factors for infection, compatible symptoms, history of infection or COVID-19, nasopharyngeal swab test were recorded. Data were expressed as median [range]. The χ2 test, Student's t-test, logistic regression analysis was used.
IBD cohort at W1 and W2 included 85 patients: 45 CD (52.9%), 40 UC (47.1%). When comparing the same 85 patients at W2 vs. W1, a higher SARS-CoV-2 seroprevalence at W2 was at the limit of the statistical significance (9.4% vs. 2.3%; p=0.05). The prevalence of COVID-19 at W2 vs. W1 was 3.5% (3/85) vs. 0% (0/85) (p=0.08). Contacts with COVID-19 patients and symptoms compatible with COVID-19 were more frequent at W2 vs. W1 (18.8 % vs. 0%; p=0.0001; 34.1% vs. 15.3%; p=0.004). At W2, history of contacts and new onset diarrhea were more frequent in seropositive patients [4/8 (50%) vs. 12/77 (15.6%); p=0.01 and 4/8 (50%) vs. 2/77 (2.6%); p=0.0001]. At W2, the risk factors for seropositivity included cough, fever, new onset diarrhea, rhinitis, arthromyalgia, dysgeusia/anosmia at univariate (p<0.05), but not at multivariate analysis. History of contacts was the only risk factor for seropositivity at univariate (p=0.03), but not at multivariate analysis (p=0.1).
During W2, characterized by a high viral spread, IBD and biologics appeared not to increase the prevalence of SARS-CoV-2 infection or COVID-19 disease. New onset diarrhea mimicking IBD relapse may be observed in patients with SARS-CoV-2 infection.
在一项前瞻性研究中，我们使用生物制剂评估了炎症性肠病（IBD）患者队列在第二波（W2）期间的 SARS-CoV-2 IgG 血清阳性率。次要目的是在同一队列中比较第二波（W2）与第一波（W1）期间的血清阳性率和 COVID-19 患病率。
从 2020 年 11 月至 2021 年 3 月，我们使用已在 W1 研究过的生物制剂评估了 IBD 患者队列的 SARS-CoV-2 IgG 血清阳性率和 COVID-19 患病率。
年龄≥18 岁；IBD 诊断；随访；书面同意。
SARS-CoV-2 疫苗接种。记录感染的危险因素、症状、感染史或 COVID-19、鼻咽拭子检测。数据以中位数[范围]表示。使用 χ2 检验、学生 t 检验、逻辑回归分析。
W1 和 W2 的 IBD 队列共纳入 85 例患者：45 例 CD（52.9%），40 例 UC（47.1%）。当比较 W2 时的相同 85 例患者与 W1 时，W2 时 SARS-CoV-2 血清阳性率更高，但统计学意义不大（9.4% vs. 2.3%；p=0.05）。W2 时 COVID-19 的患病率为 3.5%（3/85），W1 时为 0%（0/85）（p=0.08）。与 COVID-19 患者的接触和与 COVID-19 相符的症状在 W2 时更常见，而在 W1 时没有（18.8% vs. 0%；p=0.0001；34.1% vs. 15.3%；p=0.004）。在 W2 时，血清阳性患者中更常出现接触史和新发腹泻[4/8（50%）vs. 12/77（15.6%）；p=0.01 和 4/8（50%）vs. 2/77（2.6%）；p=0.0001]。在 W2 时，咳嗽、发热、新发腹泻、鼻炎、关节痛、味觉/嗅觉障碍等单变量因素（p<0.05）与血清阳性相关，但多变量分析则无相关性。接触史是血清阳性的唯一单变量危险因素（p=0.03），但多变量分析则没有（p=0.1）。
在 W2 期间，病毒传播率较高，但 IBD 和生物制剂似乎并未增加 SARS-CoV-2 感染或 COVID-19 疾病的患病率。SARS-CoV-2 感染可能会出现类似 IBD 复发的新发腹泻。
