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Martínez-Domínguez SJ, García-Mateo S, Sainz-Arnal P, Martínez-García J, Gallego-Llera B, Lozano-Limones MJ, Hidalgo S, Gargallo-Puyuelo CJ, Latre-Santos M, Nocito-Colon MML, Martínez-Lostao L, Refaie E, Arroyo-Villarino MT, Del Rio-Nechaevsky M, Ramirez-Labrada A, Pardo J, Gomollón F, Baptista PM. Unravelling the cellular response to the SARS-COV-2 vaccine in inflammatory bowel disease patients on biologic drugs. Sci Rep 2023; 13:23061. [PMID: 38155275 PMCID: PMC10754931 DOI: 10.1038/s41598-023-50537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/21/2023] [Indexed: 12/30/2023] Open
Abstract
Suboptimal vaccine response is a significant concern in patients with Inflammatory Bowel Disease (IBD) receiving biologic drugs. This single-center observational study involved 754 patients with IBD. In Phase I (October 2020-April 2021), 754 IBD participants who had not previously received the SARS-CoV-2 vaccine, underwent blood extraction to assess the seroprevalence of SARS-CoV-2 infection and IBD-related factors. Phase II (May 2021-October 2021) included a subgroup of 52 IBD participants with confirmed previous SARS-CoV-2 infection, who were studied for humoral and cellular response to the SARS-CoV-2 vaccine. In Phase I, treatment with anti-TNF was associated with lower rates of seroconversion (aOR 0.25 95% CI [0.10-0.61]). In Phase II, a significant increase in post-vaccination IgG levels was observed regardless of biologic treatment. However, patients treated with anti-TNF exhibited significantly lower IgG levels compared to those without IBD therapy (5.32 ± 2.47 vs. 7.99 ± 2.59 U/ml, p = 0.042). Following vaccination, a lymphocyte, monocyte, and NK cell activation pattern was observed, with no significant differences between patients receiving biologic drugs and those without IBD treatment. Despite lower seroprevalence and humoral response to the SARS-CoV-2 vaccine in patients treated with anti-TNF, the cellular response to the vaccine did not differ significantly from that patients without IBD therapy.
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Affiliation(s)
- Samuel J Martínez-Domínguez
- Digestive Diseases Department, University Hospital "Lozano Blesa", Av. San Juan Bosco, nº 15. PC: 50009, Zaragoza, Spain.
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain.
- University of Zaragoza, Zaragoza, Spain.
| | - Sandra García-Mateo
- Digestive Diseases Department, University Hospital "Lozano Blesa", Av. San Juan Bosco, nº 15. PC: 50009, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | | | - Javier Martínez-García
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | | | | | - Sandra Hidalgo
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | - Carla J Gargallo-Puyuelo
- Digestive Diseases Department, University Hospital "Lozano Blesa", Av. San Juan Bosco, nº 15. PC: 50009, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | - Marta Latre-Santos
- Digestive Diseases Department, University Hospital "Lozano Blesa", Av. San Juan Bosco, nº 15. PC: 50009, Zaragoza, Spain
| | | | - Luis Martínez-Lostao
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- Immunology Department, University Hospital "Lozano Blesa", Zaragoza, Spain
- Institute of Nanoscience and Material of Aragón (INMA), Zaragoza, Spain
| | - Engy Refaie
- Scuola di Specializzazione in Chirurgia Generale, Università Degli Studi di Pavia Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Maria Teresa Arroyo-Villarino
- Digestive Diseases Department, University Hospital "Lozano Blesa", Av. San Juan Bosco, nº 15. PC: 50009, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | - Marcela Del Rio-Nechaevsky
- CIBEREnfermedadesRaras (CIBERER), Madrid, Spain
- Biomedical Engineering Department, Universidad Carlos III de Madrid, Madrid, Spain
- IIS-Fundación Jiménez Díaz, Madrid, Spain
| | - Ariel Ramirez-Labrada
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Julián Pardo
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- CIBER Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
| | - Fernando Gomollón
- Digestive Diseases Department, University Hospital "Lozano Blesa", Av. San Juan Bosco, nº 15. PC: 50009, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- CIBER Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Pedro M Baptista
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Biomedical Engineering Department, Universidad Carlos III de Madrid, Madrid, Spain
- CIBER Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain
- Fundación ARAID, Zaragoza, Spain
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Nakamura M, Kitagawa A, Tamura Y, Mineo E, Takanashi M, Honda T, Shikata F, Hirata Y, Miyaji K, Ishikura K. Successful treatment of fulminant myocarditis due to COVID-19 in a 5-year-old girl. J Cardiol Cases 2023; 28:233-235. [PMID: 38126050 PMCID: PMC10730277 DOI: 10.1016/j.jccase.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/14/2023] [Accepted: 08/02/2023] [Indexed: 12/23/2023] Open
Abstract
Reports of acute myocarditis are increasing due to the worldwide spread of coronavirus disease 2019 (COVID-19). We report a case of a 5-year-old girl with fulminant myocarditis caused by COVID-19, who was successfully treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The unvaccinated patient had developed fever 1 week before attending our hospital and was "presumptive positive" for COVID-19 based on the surrounding infectious situation. The fever resolved, but the day before the visit, abdominal pain appeared. The patient visited her previous physician with vomiting as the main complaint. She was transferred to our hospital due to impaired consciousness and bradycardia, with a heart rate of 40 beats/min. Immediately after transfer, she was diagnosed with complete atrioventricular (AV) block and was scheduled to undergo percutaneous pacing lead insertion. However, the patient had ventricular tachycardia, AV block and hypotension intraoperatively and required cardiopulmonary resuscitation. The patient was in an extremely unstable circulatory state, and VA-ECMO was urgently introduced. After multidisciplinary treatment for acute myocarditis, waiting for an improvement in AV block, and recovery of cardiac function, the patient was weaned from VA-ECMO on the eighth day after admission. The patient was discharged with no cardiac or neurologic sequelae. Learning objective The rapid introduction of veno-arterial extracorporeal membrane oxygenation for fulminant myocarditis caused by coronavirus disease 2019 (COVID-19) in young children is extremely effective. Vaccination may be important for preventing infection with COVID-19 and avoiding severe complications.
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Affiliation(s)
- Maki Nakamura
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Atsushi Kitagawa
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yuhei Tamura
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Eri Mineo
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Manabu Takanashi
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takashi Honda
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Fumiaki Shikata
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Yoichiro Hirata
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kagami Miyaji
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kenji Ishikura
- Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan
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