The risk of COVID-19 in IBD patients is increased by urban living and is not influenced by disease activity or intravenous biologics
Margaux Lelong
(1)
,
Régis Josien
(2, 3)
,
Marianne Coste-Burel
(4, 3)
,
Marie Rimbert
(4, 3)
,
Céline Bressollette-Bodin
(2, 3)
,
Stéphane Nancey
(5, 6)
,
Guillaume Bouguen
(7, 8, 9)
,
Matthieu Allez
(10, 11)
,
Mélanie Serrero
(12)
,
Ludovic Caillo
(13)
,
Cléa Rouillon
(14)
,
Pierre Blanc
(15, 16)
,
David Laharie
(17, 18)
,
Raphaël Olivier
(19)
,
Laurent Peyrin-Biroulet
(20, 21)
,
Nina Dib
(22)
,
Astrid de Maissin
(23)
,
Céline Montuclard
(24)
,
Caroline Trang-Poisson
(1)
,
Fabienne Vavasseur
(1)
,
Géraldine Gallot
(3)
,
Mathilde Berthome
(3)
,
Cécile Braudeau
(2, 3)
,
Justine Chevreuil
(4, 3)
,
Arnaud Bourreille
(1)
,
Catherine Le Berre
(1)
1
CIC Nantes -
Centre d’Investigation Clinique de Nantes
2 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
3 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
4 Nantes Univ - Nantes Université
5 CIRI - Centre International de Recherche en Infectiologie
6 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
7 CIC - Centre d'Investigation Clinique [Rennes]
8 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
9 NuMeCan - Nutrition, Métabolismes et Cancer
10 EMily (UMR_S_1160 / U1160) - Ecotaxie, microenvironnement et développement lymphocytaire
11 AP-HP - Hopital Saint-Louis [AP-HP]
12 CHU Marseille
13 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
14 CHU Caen
15 UM - Université de Montpellier
16 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
17 CIC Bordeaux
18 Centre médico chirurgical Magellan - Hôpital Haut-Lévêque - CHU de Bordeaux
19 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
20 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
21 Service d'Hépato-gastro-entérologie [CHRU Nancy]
22 CHU Angers - Centre Hospitalier Universitaire d'Angers
23 CHD Vendée - Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon
24 Centre hospitalier de Valence
2 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
3 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
4 Nantes Univ - Nantes Université
5 CIRI - Centre International de Recherche en Infectiologie
6 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
7 CIC - Centre d'Investigation Clinique [Rennes]
8 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
9 NuMeCan - Nutrition, Métabolismes et Cancer
10 EMily (UMR_S_1160 / U1160) - Ecotaxie, microenvironnement et développement lymphocytaire
11 AP-HP - Hopital Saint-Louis [AP-HP]
12 CHU Marseille
13 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
14 CHU Caen
15 UM - Université de Montpellier
16 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
17 CIC Bordeaux
18 Centre médico chirurgical Magellan - Hôpital Haut-Lévêque - CHU de Bordeaux
19 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
20 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
21 Service d'Hépato-gastro-entérologie [CHRU Nancy]
22 CHU Angers - Centre Hospitalier Universitaire d'Angers
23 CHD Vendée - Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon
24 Centre hospitalier de Valence
Catherine Le Berre
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Résumé
Background: Patients with inflammatory bowel disease (IBD) may have a modified immune response to SARS-CoV-2. The objectives were to evaluate the prevalence of COVID-19 in patients treated with infliximab or vedolizumab, to analyze the factors associated with the infection, the impact of treatments and trough levels.Methods: Patients with IBD treated with intravenous biologics in 14 French centers were included between March and June 2020 and followed-up for 6 months. Blood samples were collected for serologies and trough levels. The analysis of factors associated with COVID-19 was conducted in a matched 1:1 case-control sub-study with positive patients.Results: In total, 1026 patients were included (74.9% infliximab). Over the follow-up period, 420 patients reported the occurrence of COVID-19 symptoms; 342 had been tested of whom 18 were positive. At the end of follow-up, 38 patients had a positive serology. Considering both nasal tests and serologies together, 46 patients (4.5%) had been infected. The risk of COVID-19 was related neither to the use of treatments (whatever the trough levels) nor to disease activity. Infections were more frequent when using public transport or living in flats in urban areas.Conclusions: The prevalence rate of COVID-19 in this IBD population treated with intravenous infliximab or vedolizumab was the same as the one in the French population before the start of the vaccination campaign. The risk was increased by urban living and was not influenced by disease activity or biologics. Sanitary barrier measures remain the best way to protect against SARS-CoV-2 in patients with IBD in biological therapy.