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Geography Influences Susceptibility to SARS-CoV-2 Serological Response in Patients With Inflammatory Bowel Disease: Multinational Analysis From the ICARUS-IBD Consortium.

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Affiliations

  • 1. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
      Authors
    • Wong SY 1
    • Helmus D 1
    • Martinez Pazos V 1
    • Moran HR 1
    • Colombel JF 1
    (5 authors)
  • 2. Department of Gastroenterology and Hepatology, Leuven University Hospitals, Leuven, Belgium.
      Authors
    • Wellens J 2
    • Vermeire S 2
    (2 authors)
  • 3. Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
      Authors
    • Marlow L 3
    • Brann S 3
    • McGregor C 3
    • Satsangi J 3
    (4 authors)
  • 4. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
      Authors
    • Weinberg A 4
    (1 author)
  • 5. Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
      Authors
    • Watanabe K 5
    • Kamikozuru K 5
    (2 authors)
    • Show all (12)

ORCIDs linked to this article

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Inflammatory Bowel Diseases, 01 Nov 2023, 29(11):1693-1705
https://doi.org/10.1093/ibd/izad097 PMID: 37354560 

A comment on this article appears in "SARS-CoV-2 Serological Response in Patients With Inflammatory Bowel Disease." Inflamm Bowel Dis. 2023 Oct 10;:.

Abstract 

Background

Beyond systematic reviews and meta-analyses, there have been no direct studies of serological response to COVID-19 in patients with inflammatory bowel disease (IBD) across continents. In particular, there has been limited data from Asia, with no data reported from India. The ICARUS-IBD (International study of COVID-19 Antibody Response Under Sustained immunosuppression in IBD) consortium assessed serological response to SARS-CoV-2 in patients with IBD in North America, Europe, and Asia.

Methods

The ICARUS-IBD study is a multicenter observational cohort study spanning sites in 7 countries. We report seroprevalence data from 2303 patients with IBD before COVID-19 vaccination between May 2020 and November 2021. SARS-CoV-2 anti-spike and anti-nucleocapsid antibodies were analyzed.

Results

The highest and lowest SARS-CoV-2 anti-spike seropositivity rates were found in Asia (81.2% in Chandigarh and 57.9% in Delhi, India; and 0% in Hong Kong). By multivariable analysis, country (India: odds ratio [OR], 18.01; 95% confidence interval [CI], 12.03-26.95; P < .0001; United Kingdom: OR, 2.43; 95% CI, 1.58-3.72; P < .0001; United States: OR, 2.21; 95% CI, 1.27-3.85; P = .005), male sex (OR, 1.46; 95% CI, 1.07-1.99; P = .016), and diabetes (OR, 2.37; 95% CI, 1.04-5.46; P = .039) conferred higher seropositivity rates. Biological therapies associated with lower seroprevalence (OR, 0.22; 95% CI, 0.15-0.33; P < .0001). Multiple linear regression showed associations between anti-spike and anti-nucleocapsid titers with medications (P < .0001) but not with country (P = .3841).

Conclusions

While the effects of medications on anti-SARS-CoV-2 antibody titers in patients with IBD were consistent across sites, geographical location conferred the highest risk of susceptibility to serologically detectable SARS-CoV-2 infection. Over half of IBD patients in India were seropositive prior to vaccination. These insights can help to inform shielding advice, therapeutic choices, and vaccine strategies in IBD patients for COVID-19 and future viral challenges.

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Read article at publisher's site: https://doi.org/10.1093/ibd/izad097

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Funding 

Funders who supported this work.

All India Institute of Medical Sciences Institute (2)

Chandigarh Institutional Ethics Committee (1)

Digestive System in Children and Adults (2)

Postgraduate Institute of Medical Education and Research