The association of three vaccination doses with reduced gastrointestinal symptoms after severe acute respiratory syndrome coronavirus 2 infections in patients with inflammatory bowel disease

Yu Hong; Tianyi Che; Xiangguo Shen; Jie Chen; Kui Wang; Lingying Zhao; Weitong Gao; Yao Zhang; Wensong Ge; Yubei Gu; Duowu Zou

doi:10.3389/fmed.2024.1377926

The association of three vaccination doses with reduced gastrointestinal symptoms after severe acute respiratory syndrome coronavirus 2 infections in patients with inflammatory bowel disease

Front Med (Lausanne). 2024 Mar 18:11:1377926. doi: 10.3389/fmed.2024.1377926. eCollection 2024.

Authors

Yu Hong^#¹, Tianyi Che^#¹, Xiangguo Shen^#², Jie Chen³, Kui Wang¹, Lingying Zhao¹, Weitong Gao¹, Yao Zhang¹, Wensong Ge⁴, Yubei Gu¹, Duowu Zou¹

Affiliations

¹ Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Department of Gastroenterology, Shanghai Wusong Central Hospital (Zhongshan Hospital Wusong Branch, Fudan University), Shanghai, China.
³ School of Public Health and The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
⁴ Department of Gastroenterology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Background: The protective efficacy of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination against the new-onset gastrointestinal (GI) symptoms following COVID-19 infection is critical among patients with inflammatory bowel disease (IBD); however, the optimal protective vaccine dose remains unknown. Therefore, this study aimed to clarify whether there is a correlation between SARS-CoV-2 vaccinations and GI symptoms following Omicron infection in patients with IBD.

Methods: We conducted a multicenter cross-sectional study of IBD patients among three tertiary hospitals in eastern China. Professional physicians collected all data using online questionnaires. The patients were stratified into four groups: patients who were unvaccinated and patients who received one, two, or three vaccination doses. The primary outcome was the presence of any new-onset GI symptoms after SARS-CoV-2 infection before a negative SARS-CoV-2 nucleic acid test or a negative self-testing for antigens.

Results: In total, 536 patients with IBD (175 unvaccinated, 31 vaccinated, 166 vaccinated with two doses, and 164 vaccinated with three doses) reported having COVID-19 infection. Compared with the unvaccinated, the three vaccination doses group was associated with reduced GI symptoms after infection (adjusted odds ratio = 0.56, 95% confidence interval 0.34-0.90, P < 0.05). Reduced diarrhea (adjusted odds ratio = 0.54, 95% confidence interval 0.31-0.92, P < 0.05) and nausea or vomiting (adjusted odds ratio = 0.45, 95% confidence interval 0.21-0.92, P < 0.05) were observed in the three vaccination doses group compared with the unvaccinated group.

Conclusions: In conclusion, in the 536 patients with IBD who reported COVID-19 infection, we found that the three vaccination doses, but not the one or two doses group, were associated with reduced GI symptoms after infection compared with the unvaccinated group.

Keywords: SARS-CoV-2 vaccine; activity; duration; gastrointestinal symptoms; inflammatory bowel disease; three vaccination doses.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the National Natural Science Foundation of China [grant number: 82170559] and the Qingfeng Scientific Research Fund of the China Crohn's & Colitis Foundation (CCCF) [grant number: CCCF-QF-2023B46-27].