Document Type

Article

Publication Date

7-1-2022

Publication Title

Inflammatory bowel diseases

Keywords

JGM, Adolescent, Adult, Angiotensin-Converting Enzyme 2, Antibodies, Neutralizing, Antibodies, Viral, Antibody Formation, COVID-19, COVID-19 Vaccines, Child, Child, Preschool, Female, HEK293 Cells, Humans, Immunoglobulin G, Inflammatory Bowel Diseases, Longitudinal Studies, Male, Prospective Studies, SARS-CoV-2, Spike Glycoprotein, Coronavirus, Vaccination, Young Adult

JAX Source

Inflamm Bowel Dis 2022 Jul 1; 28(7):1019-1026

Volume

28

Issue

7

First Page

1019

Last Page

1026

ISSN

1536-4844

PMID

34528661

DOI

https://doi.org/10.1093/ibd/izab207

Abstract

BACKGROUND: Characterization of neutralization antibodies to SARS-CoV-2 infection or vaccination in children and young adults with inflammatory bowel disease (IBD) receiving biologic therapies is crucial.

METHODS: We performed a prospective longitudinal cohort study evaluating SARS-CoV-2 spike protein receptor binding domain (S-RBD) IgG positivity along with consistent clinical symptoms in patients with IBD receiving infliximab or vedolizumab. Serum was also obtained following immunization with approved vaccines. The IgG antibody to the spike protein binding domain of SARS-CoV-2 was assayed with a fluorescent bead-based immunoassay that takes advantage of the high dynamic range of fluorescent molecules using flow cytometry. A sensitive and high-throughput neutralization assay that incorporates SARS-CoV-2 spike protein onto a lentivirus and measures pseudoviral entry into ACE2-angiotensin converting enzyme 2 (ACE2) expressing human embryonic kidney 293 (HEK-293) cells was used.

RESULTS: There were 436 patients enrolled (mean age, 17 years, range 2-26 years; 58% male; 71% Crohn's disease, 29% ulcerative colitis, IBD-unspecified). Forty-four (10%) of enrolled subjects had SARS-CoV-2 S-RBD IgG antibodies. Compared to non-IBD adults (ambulatory) and hospitalized pediatric patients with PCR documented SARS-CoV-2 infection, S-RBD IgG antibody levels were significantly lower in the IBD cohort and by 6 months post infection most patients lacked neutralizing antibody. Following vaccination (n = 33), patients had a 15-fold higher S-RBD antibody response in comparison with natural infection, and all developed neutralizing antibodies to both wild type and variant SARS-CoV-2.

CONCLUSIONS: The lower and less durable SARS-CoV-2 S-RBD IgG response to natural infection in IBD patients receiving biologics puts them at risk of reinfection. The robust response to immunization is likely protective.

Comments

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License.

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