P827 SARS-CoV-2 breakthrough infections after COVID-19 vaccination in patients with Inflammatory Bowel Disease: A systematic review and meta-analysis
| العنوان: | P827 SARS-CoV-2 breakthrough infections after COVID-19 vaccination in patients with Inflammatory Bowel Disease: A systematic review and meta-analysis |
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| المؤلفون: | N Van De Pol, Q Pan, L A A P Derikx, L Bakker, C J van der Woude, A C de Vries |
| المصدر: | Journal of Crohn's and Colitis. 17:i960-i961 |
| بيانات النشر: | Oxford University Press (OUP), 2023. |
| سنة النشر: | 2023 |
| مصطلحات موضوعية: | Gastroenterology, General Medicine |
| الوصف: | Background Patients with inflammatory bowel disease (IBD) have reduced seroconversion rates to COVID-19 vaccination. It is unclear whether an impaired immune response in vaccinated IBD patients impacts the susceptibility to SARS-CoV-2 infection and occurrence of (severe) COVID-19. We evaluated SARS-CoV-2 breakthrough infection rates and the disease course of COVID-19 in vaccinated IBD patients. Methods A systematic literature search was performed for studies which reported SARS-CoV-2 breakthrough infection rates and/or the disease course of COVID-19 in patients with IBD after COVID-19 vaccination. Primary outcome was the rates of breakthrough infection per time period. In meta-analyses, the pooled relative risk was calculated with a random effects model for vaccinated patients compared to vaccinated controls, to partially vaccinated and unvaccinated patients with IBD. Results A total of 16 studies were included in analysis. The study period ranged from January 2020 to October 2021, and a follow-up time ranges from 3 weeks to 6 months. The breakthrough infection rates range from 0 to 37.4% in IBD patients within the study follow-up time. Strikingly, only studies with vaccination prior to December 2021 showed a breakthrough infection rate above 2%. (Figure 1). The disease course of a breakthrough infection is generally mild, with mild constitutional and respiratory symptoms in 85% of infected IBD patients. Hospitalization and mortality rates are low (0-8.7% and 0-4.3% respectively). Meta-analyses showed a significantly lower pooled relative risk of breakthrough infection for vaccinated as compared to unvaccinated IBD patients (RR 0.07, 95% CI 0.03; 0.18). No difference was observed in risk of breakthrough infections between IBD patients and non-IBD controls (RR 1.01, 95% CI 0.92; 1.10), and no difference between vaccinated and partially vaccinated IBD patients (RR 0.67, 95% CI 0.38; 1.18). The impact of immunosuppressive therapy on breakthrough infection rates differs between studies. One study reported higher breakthrough infection rates for patients treated with infliximab in comparison to vedolizumab (P Conclusion Vaccination is effective to prevent COVID-19 infections in patients with IBD. Breakthrough infections do occur, but the disease course is generally mild. Available data seem to suggest a declining trend of breakthrough infections during calendar time. Data on the impact of IBD medication on the rate of breakthrough infections and disease course require further elucidation. |
| تدمد: | 1876-4479 1873-9946 |
| DOI: | 10.1093/ecco-jcc/jjac190.0957 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::674d12e7d26177225f7db798a58c991c https://doi.org/10.1093/ecco-jcc/jjac190.0957 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi...........674d12e7d26177225f7db798a58c991c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18764479 18739946 |
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| DOI: | 10.1093/ecco-jcc/jjac190.0957 |