Impact of the COVID-19 outbreak and the serum prevalence of SARS-CoV-2 antibodies in patients with inflammatory bowel disease treated with biologic drugs

Abstract

Background: Patients receiving biologic therapies are at risk for viral infections. This study investigated the impact of the SARS-CoV-2 infection and the serum prevalence of SARS-CoV-2 antibodies in patients with inflammatory bowel disease (IBD) treated with biologic drugs.

Methods: Information on demography, co-morbidities, clinical data regarding IBD, symptoms suggestive of the SARS-CoV-2 infection, close contacts with SARS-CoV-2 positive patients, hospitalization, and therapies administered for COVID-19 was collected for all patients who were being treated with biologic drugs. All patients underwent SARS-CoV-2 antibody testing.

Results: Two hundred and fifty-nine patients (27 children) with a mean age of 42.2 ± 16.7 years (range 9 - 88) and a mean duration of disease of 13.4 ± 10 years (range 0.2 - 49) were enrolled. One hundred four patients (40.2%) had ulcerative colitis, and 155 (59.8%) had Crohn's disease. About the therapy: 62 patients were receiving infliximab, 89 adalimumab, 20 golimumab, 57 vedolizumab, 27 ustekinumab, 1 thalidomide, and 3 an experimental compound. The mean Charlson Comorbidity Index was 2. Thirty-two patients (12.3%) reported respiratory symptoms, and 2 of them were hospitalized (0.77%). Two patients resulted positive for IgG against SARS-CoV-2 (0.77%).

Conclusions: In patients with IBD, treatment with biologic drug does not represent a risk factor for the SARS-CoV-2 infection.

Keywords: Biologic therapy; IBD; SARS-CoV-2.

Fig. 1

Chest CT scan images at the time of hospital admission (A and B) and before discharge (C and D). Baseline CT images (A-B) show bilateral ground glass opacities with a peripheral and posterior distribution, mainly in the lower lobes, in association with thickened interlobular lines. Small pulmonary nodules are also present in the right lower lobe, many of them distributed in the secondary lobules. Ground glass opacifications localized in lower lobes evolve into parenchymal bands and perilobular consolidations at follow-up CT images (C-D), suggesting the possible presence of organizing pneumonia.

Fig. 2

SARS-CoV-2 IgM/IgG antibodies serum results detected using the rapid serological test and the ELISA test after urea dissociation in sera positive on both methods. At the final evaluation, only 2 patients were considered definitely positive, as confirmed by the ELISA test after urea dissociation. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)