A booster dose of SARS-COV-2 vaccine improves suboptimal seroconversion rates in patients with inflammatory bowel disease. Results of a prospective multicenter study of GETECCU (VACOVEII study)

BACKGROUND

The response to SARS-CoV-2 vaccination decreases in inflammatory bowel disease (IBD) patients, specially under anti-TNF treatment. However, data on medium-term effectiveness are limited, specially using new recommended seroconversion rate (>260BAU/mL). Our aim was to evaluate the 6-month>260 BAU-seroconversion rate after full vaccination and after booster-dose.

METHODS

VACOVEII is a Spanish multicenter, prospective study promoted by GETECCU. IBD patients full vaccinated against SARS-CoV-2 and without previous COVID-19 infection, treated or not with immunosuppressants, were included. The booster dose was administered 6 months after the full vaccination. Seroconversion was set at 260BAU/mL, according to most recent recommendations and was assessed 6 months after the full vaccination and 6 months after booster-dose.

RESULTS

Between October 2021 and March 2022, 313 patients were included (124 no treatment or mesalazine; 55 immunomodulators; 87 anti-TNF; 19 anti-integrin; and 28 ustekinumab). Most patients received mRNA-vaccines (86%). Six months after full vaccination, overall seroconversion rate was 44.1%, being significantly lower among patients on anti-TNF (19.5%, p<0.001) and ustekinumab (35.7%, p=0.031). The seroconversion rate after booster was 92%. Again, anti-TNF patients had a significantly lower seroconversion rate (67%, p<0.001). mRNA-vaccine improved seroconversion rate (OR 11.720 [95% CI 2.26-60.512]).

CONCLUSION

The full vaccination regimen achieves suboptimal response in IBD patients, specially among those anti-TNF or ustekinumab. The booster dose improves seroconversion rate in all patients, although it remains limited in those treated with anti-TNF. These results reinforce the need to prioritize future booster doses in patients on immunosuppressants therapy, specially under anti-TNF, and using mRNA-vaccines.

Appendicular invagination as a rare manifestation of endometriosis

Appendicular invagination is a rare situation, with an incidence of 0.01 %. The clinical presentation can be variable from acute appendicitis to chronic abdominal pain, intestinal obstruction by intussusception or simply appear as a radiologic or intraoperative finding. Endometriosis is the underlying cause of appendicular invagination in one-third of cases but the possibility of neoplastic pathology should always be considered in these cases.

[Soluble, insoluble and total dietary fiber in raw and cooked legumes]

Soluble (SDF), Insoluble (IDF) and total dietary fiber (TDF) were analysed in 26 samples of the following legumes: Peas (Pisum sativum L) coated and uncoated; beans (Phaseolus vulgaris L), beans (Vigna sinesis L), chick peas (Cicer arietinum L), lentils (Lens culinaris L) and pigeon peas (Cajanus indicus L) raw and cooked, purchased at wholesale level. The AOAC enzimatic-gravimetric method (1990) was used. The cooked grains were drained and dried before analysis. Values for TDF in the raw legumes were 13.6 and 28.9% in chick peas and white beans respectively. In processed grains, values varied from 16.1 and 27.0% in yellow peas uncoated and black beans respectively. As expected the values for IDF were greater in all samples than those for SDF.