Vaccination reduces risk for severe adverse events in IBD patients with COVID-19
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Patients with inflammatory bowel disease who are fully vaccinated against COVID-19 have a lower risk for adverse events when diagnosed with a breakthrough infection, according to a presenter at the Crohn’s and Colitis Congress.
“Overall, we saw that vaccinated patients who subsequently developed COVID-19 had low rates of hospitalization, severe COVID-19 and death,” Emily Spiera, a medical student at the Icahn School of Medicine at Mount Sinai in New York, said during the presentation. “The risk factors that we found were use of a non-mRNA vaccine, older age and being on combination therapy at time of infection.”
Spiera and colleagues assessed data from 2,477 patients with COVID-19 in the Surveillance Epidemiology of Coronavirus Under Research Exclusion-IBD database. Of those, 160 patients said they were vaccinated and 53 said they were partially vaccinated. The majority of patients had received one of the mRNA vaccines (Moderna or Pfizer), with the remainder receiving either an adenovirus vector vaccine (AstraZeneca, CanSino, Janssen or Sputnik) or an inactivated SARS-CoV-2 vaccine (Sinovac). Patients who did not receive the full complement of doses were considered partially vaccinated.
Researchers analyzed data from 88 patients who had completed the primary vaccination series at the time of COVID-19 diagnosis and considered the following outcomes: hospitalization, death, severe COVID-19, composite of ICU admission, mechanical ventilation and/or death.
According to the analysis, of those patients who received mRNA vaccines, only about 3% were hospitalized, compared with about 17% in the non-mRNA vaccination group. Further, there were fewer hospitalizations in those who were completely vaccinated compared with the non-vaccinated group (5% vs. 9%).
Spiera noted the majority of breakthrough infections were in patients on biologic monotherapy or combination therapy with a biologic and an immunomodulator. Among patients on combination therapy, about 16% were hospitalized and about 10% developed severe COVID-19.
“When comparing IBD medications, we saw that patients on combination therapy had the poorest outcomes,” Spiera said. “This is consistent with other data that has come out of SECURE-IBD that has shown this in patients who are not vaccinated prior to their infection.”
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Spiera E, et al. COVID-19 infections in vaccinated patients with inflammatory bowel disease: Outcomes and risk factors for severe disease. Presented at: Crohn’s and Colitis Congress; Jan. 20-22, 2022 (virtual meeting).
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