SARS-CoV-2 antibody vaccine response in Inflammatory Bowel Disease patients with positive anti-nucleocapsid serology or history of COVID-19 infection

Acta Gastroenterol Belg. 2024 Apr-Jun;87(2):263-273. doi: 10.51821/87.2.12805.

Abstract

Background: Previous history of COVID-19 infection is a natural booster of the vaccine response in the general population. The response to COVID-19 vaccines is lessened in Inflammatory Bowel Disease patients on selected class of immunosuppressive treatments.

Aims: The study was to assess anti-SARS-CoV-2 spike-specific IgG antibody response in Inflammatory Bowel Disease patients with a history of COVID-19 infection.

Patients and methods: This single-center prospective study involved 504 Inflammatory Bowel Disease patients. Demographic data and clinical data were gathered through questionnaires and patient charts. Anti-SARS-CoV-2 spike-specific and antinucleocapsid antibody levels were measured at T1, T2 (after the 2-dose series), and T3 or T4 (booster vaccine).

Results: This study included 504 Inflammatory Bowel Disease patients, and 234 completed one year follow-up with blood tests. Positive anti-nucleocapsid serology or history of COVID-19 infection was significantly associated with increased median anti- SARS-CoV-2 spike-specific IgG titers after the 2-dose series (1930 BAU/mL vs. 521 BAU/mL p < 0.0001) and the booster vaccine (4390 BAU/mL vs. 2160 BAU/mL, p = 0.0156). Multivariate analysis showed that higher anti-SARS-CoV-2 spike-specific IgG levels were independently associated with anti-nucleocapsid antibodies at T2 (OR=2.23, p < 0.0001) and T3 (OR=1.72, p = 0.00011). Immunosuppressive treatments did not impact the antibody response or levels in patients with a history of COVID-19 infection or positive anti-nucleocapsid serology.

Conclusions: In Inflammatory Bowel Disease, prior COVID-19 infection or positive anti-nucleocapsid serology leads to increased anti-SARS-CoV-2 spike-specific IgG levels after vaccination, regardless of immunosuppressive treatments. This emphasizes the significance of accounting for previous infection in vaccination approaches.

Keywords: COVID-19 vaccine; anti-SARS-CoV-2 spike specific IgG antibody; antinucleocapsid antibody; inflammatory bowel disease.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Viral* / blood
  • Antibodies, Viral* / immunology
  • COVID-19 Vaccines* / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Immunization, Secondary
  • Immunoglobulin G* / blood
  • Immunoglobulin G* / immunology
  • Inflammatory Bowel Diseases* / drug therapy
  • Inflammatory Bowel Diseases* / immunology
  • Male
  • Middle Aged
  • Prospective Studies
  • SARS-CoV-2* / immunology
  • Spike Glycoprotein, Coronavirus / immunology

Substances

  • COVID-19 Vaccines
  • Antibodies, Viral
  • Immunoglobulin G
  • Spike Glycoprotein, Coronavirus