{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:19:45Z","timestamp":1760145585995,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T00:00:00Z","timestamp":1722556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Italian Ministry of Health","doi-asserted-by":"publisher","award":["RC2024"],"award-info":[{"award-number":["RC2024"]}],"id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>The etiology of Inflammatory Bowel Disease (IBD) is not fully understood but is believed to involve a dysregulated immune response to intestinal microbiota in genetically susceptible individuals. Individuals with IBD are at increased risk of infections due to immunosuppressive treatments, comorbidities, and advanced age. Current evidence indicates that IBD patients are not at higher risk of SARS-CoV-2 infection compared to the general population, though the risk of severe outcomes remains debated. A retrospective observational study was conducted using Apulian regional health data from 2020 to 2022. This study included 1029 IBD patients and 3075 controls, matched by age and sex. COVID-19 incidence, hospitalization, and case fatality rates were analyzed alongside vaccination coverage. No significant differences in COVID-19 incidence (IRR = 0.97), hospitalization (p = 0.218), or lethality (p = 0.271) were evidenced between IBD patients and the general population. Vaccination rates were high in both groups, with slightly higher uptake in IBD patients. Multivariate analysis identified age and male sex as risk factors for severe COVID-19 outcomes, while vaccination significantly reduced hospitalization and lethality risks. IBD patients in Apulia do not have an increased risk of COVID-19 infection or severe outcomes compared to the general population. Vaccination is crucial in protecting IBD patients, and ongoing efforts to promote vaccination within this population are essential. Future research should focus on the impact of specific IBD treatments on COVID-19 outcomes and the long-term effectiveness of vaccines.<\/jats:p>","DOI":"10.3390\/vaccines12080881","type":"journal-article","created":{"date-parts":[[2024,8,2]],"date-time":"2024-08-02T16:14:58Z","timestamp":1722615298000},"page":"881","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence of Severe COVID-19 Outcomes and Immunization Rates in Apulian Individuals with Inflammatory Bowel Disease: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9659-0193","authenticated-orcid":false,"given":"Francesco Paolo","family":"Bianchi","sequence":"first","affiliation":[{"name":"Health Prevention Department, Local Health Authority of Brindisi, 72100 Brindisi, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Contaldo","sequence":"additional","affiliation":[{"name":"National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5580-2739","authenticated-orcid":false,"given":"Maurizio Gaetano","family":"Polignano","sequence":"additional","affiliation":[{"name":"National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Pisani","sequence":"additional","affiliation":[{"name":"National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,2]]},"reference":[{"key":"ref_1","unstructured":"CDC (2024, March 24). Inflammatory Bowel Disease (IBD), Available online: https:\/\/www.cdc.gov\/inflammatory-bowel-disease\/?CDC_AAref_Val=https:\/\/www.cdc.gov\/ibd\/features\/IBD-more-chronic-diseases.html."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S2468-1253(16)30077-2","article-title":"Globalisation of inflammatory bowel disease: Perspectives from the evolution of inflammatory bowel disease in the UK and China","volume":"1","author":"Kaplan","year":"2016","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_3","unstructured":"GBD 2017 Inflammatory Bowel Disease Collaborators (2020). The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol. Hepatol., 5, 17\u201330."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Borowitz, S.M. (2023). The epidemiology of inflammatory bowel disease: Clues to pathogenesis?. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.1103713"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kubas, A., and Malecka-Wojciesko, E. (2022). COVID-19 Vaccination in Inflammatory Bowel Disease (IBD). J. Clin. Med., 11.","DOI":"10.3390\/jcm11092676"},{"key":"ref_6","unstructured":"CDC (2023, July 24). Inflammatory Bowel Disease (IBD). Comorbidities, Available online: https:\/\/www.cdc.gov\/inflammatory-bowel-disease\/php\/facts-stats\/index.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/j.crohns.2013.12.013","article-title":"Second European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease","volume":"8","author":"Rahier","year":"2014","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wheat, C.L., Ko, C.W., Clark-Snustad, K., Grembowski, D., Thornton, T.A., and Devine, B. (2017). Inflammatory Bowel Disease (IBD) pharmacotherapy and the risk of serious infection: A systematic review and network meta-analysis. BMC Gastroenterol., 17.","DOI":"10.1186\/s12876-017-0602-0"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1093\/ecco-jcc\/jjaa061","article-title":"Are Patients with Inflammatory Bowel Disease at Increased Risk for COVID-19 Infection?","volume":"14","author":"Monteleone","year":"2020","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1016\/j.cgh.2020.04.071","article-title":"Incidence and Patterns of COVID-19 among Inflammatory Bowel Disease Patients from the Nancy and Milan Cohorts","volume":"18","author":"Allocca","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1111\/apt.16730","article-title":"Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease: Propensity matched research network analysis","volume":"55","author":"Hadi","year":"2022","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1093\/ibd\/izab041","article-title":"COVID-19 Hospitalizations among US Medicare Beneficiaries with Inflammatory Bowel Disease, April 1 to July 31, 2020","volume":"27","author":"Xu","year":"2021","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1002\/ueg2.12049","article-title":"Inflammatory bowel disease and risk of severe COVID-19: A nationwide population-based cohort study in Sweden","volume":"9","author":"Ludvigsson","year":"2021","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105061","DOI":"10.1016\/j.phrs.2020.105061","article-title":"Clinical course of COVID-19 in 41 patients with immune-mediated inflammatory diseases: Experience from humanitas center, Milan","volume":"160","author":"Allocca","year":"2020","journal-title":"Pharmacol. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S360","DOI":"10.14309\/01.ajg.0000704916.59012.8d","article-title":"S0717 Inflammatory Bowel Disease Is Not Associated with Severe Outcomes of COVID-19: A Cohort Study from the United States Epicenter","volume":"115","author":"Hong","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1136\/gutjnl-2020-321411","article-title":"Outcomes of COVID-19 in 79 patients with IBD in Italy: An IG-IBD study","volume":"69","author":"Bezzio","year":"2020","journal-title":"Gut"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/S2468-1253(21)00024-8","article-title":"SARS-CoV-2 vaccination for patients with inflammatory bowel disease: A British Society of Gastroenterology Inflammatory Bowel Disease section and IBD Clinical Research Group position statement","volume":"6","author":"Alexander","year":"2021","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_18","unstructured":"CDC (2024, March 21). COVID-19 Vaccines for People Who Are Moderately or Severely Immunocompromised, Available online: https:\/\/www.cdc.gov\/covid\/vaccines\/immunocompromised-people.html#:~:text=CDC%20recommends%20the%202023%E2%80%932024,2024%20updated%20COVID%2D19%20vaccine."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Tabesh, E., Soheilipour, M., Rezaeisadrabadi, M., Zare-Farashbandi, E., and Mousavi-Roknabadi, R.S. (2022). Comparison the effects and side effects of COVID-19 vaccination in patients with inflammatory bowel disease (IBD): A systematic scoping review. BMC Gastroenterol., 22.","DOI":"10.1186\/s12876-022-02460-1"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/S2468-1253(22)00274-6","article-title":"COVID-19 vaccine-induced antibody and T-cell responses in immunosuppressed patients with inflammatory bowel disease after the third vaccine dose (VIP): A multicentre, prospective, case-control study","volume":"7","author":"Alexander","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1093\/ibd\/izab302","article-title":"Impact of SARS-CoV-2 Vaccination on Inflammatory Bowel Disease Activity and Development of Vaccine-Related Adverse Events: Results from PREVENT-COVID","volume":"28","author":"Weaver","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.dld.2022.03.005","article-title":"Safety of SARS-CoV-2 vaccination in patients with inflammatory bowel disease: A systematic review and meta-analysis","volume":"54","author":"James","year":"2022","journal-title":"Dig. Liver Dis."},{"key":"ref_23","unstructured":"Italian Ministry of Health (2024, March 07). Recommendations on Target Groups of SARS-CoV-2\/COVID-19 Vaccination, Available online: https:\/\/www.trovanorme.salute.gov.it\/norme\/renderPdf.spring?seriegu=SG&datagu=24\/03\/2021&redaz=21A01802&artp=1&art=1&subart=1&subart1=10&vers=1&prog=002."},{"key":"ref_24","unstructured":"Italian Ministry of Health (2024, April 12). 2023\u20132024 Recommendations for COVID-19 Vaccination, Available online: https:\/\/www.epicentro.iss.it\/vaccini\/vaccini-covid-19-raccomandazioni-23-24."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1111\/bjh.18731","article-title":"Burden of COVID-19 disease and vaccine coverages in Apulian splenectomized patients: A retrospective observational study","volume":"201","author":"Bianchi","year":"2023","journal-title":"Br. J. Haematol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Abdulla, M., Mohammed, N., AlQamish, J., and Mosli, M. (2022). Inflammatory bowel disease and COVID-19 outcomes: A meta-analysis. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-25429-2"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"84","DOI":"10.21315\/mjms2023.30.3.7","article-title":"Risk Factors Associated with the Severity of COVID-19","volume":"30","author":"Mulyanti","year":"2023","journal-title":"Malays. J. Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1029190","DOI":"10.3389\/fpubh.2022.1029190","article-title":"Sex-differences in COVID-19 diagnosis, risk factors and disease comorbidities: A large US-based cohort study","volume":"10","author":"Kharroubi","year":"2022","journal-title":"Front Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Bianchi, F.P., Donghia, R., Tatoli, R., and Bonfiglio, C. (2023). COVID-19 Immunization Rates in Patients with Inflammatory Bowel Disease Worldwide: A Systematic Review and Meta-Analysis. Vaccines, 11.","DOI":"10.3390\/vaccines11101523"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Guarducci, G., Mereu, G., Golinelli, D., Galletti, G., Gemmi, F., Cartocci, A., Holczer, N., Bacci, L., Sergi, A., and Messina, G. (2023). Factors Influencing the Healthcare Workers\u2019 Willingness to Receive the COVID-19 Booster Dose in Tuscany (Italy). Vaccines, 11.","DOI":"10.3390\/vaccines11121751"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100614","DOI":"10.1016\/j.lanepe.2023.100614","article-title":"Attitudes towards booster, testing and isolation, and their impact on COVID-19 response in winter 2022\/2023 in France, Belgium, and Italy: A cross-sectional survey and modelling study","volume":"28","author":"Valdano","year":"2023","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2349319","DOI":"10.1080\/21645515.2024.2349319","article-title":"Role of gastroenterologists and healthcare providers in promoting COVID-19 immunization among individuals with inflammatory bowel disease: A systematic review and meta-analysis on a global scale","volume":"20","author":"Bianchi","year":"2024","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1093\/ibd\/izab236","article-title":"COVID-19 and Outcomes in Patients with Inflammatory Bowel Disease: Systematic Review and Meta-Analysis","volume":"28","author":"Tripathi","year":"2022","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Picchianti-Diamanti, A., Aiello, A., Lagan\u00e0, B., Agrati, C., Castilletti, C., Meschi, S., Farroni, C., Lapa, D., Najafi Fard, S., and Cuzzi, G. (2021). ImmunosuppressiveTherapies Differently Modulate Humoral- and T-Cell-Specific Responses to COVID-19 mRNA Vaccine in Rheumatoid Arthritis Patients. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.740249"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Picchianti-Diamanti, A., Navarra, A., Aiello, A., Lagan\u00e0, B., Cuzzi, G., Salmi, A., Vanini, V., Maggi, F., Meschi, S., and Matusali, G. (2023). Older Age, a High Titre of Neutralising Antibodies and Therapy with Conventional DMARDs Are Associated with Protection from Breakthrough Infection in Rheumatoid Arthritis Patients after the Booster Dose of Anti-SARS-CoV-2 Vaccine. Vaccines, 11.","DOI":"10.3390\/vaccines11111684"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/imr.13089","article-title":"Immunological memory to SARS-CoV-2 infection and COVID-19 vaccines","volume":"310","author":"Sette","year":"2022","journal-title":"Immunol. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Petrone, L., Sette, A., de Vries, R.D., and Goletti, D. (2023). The Importance of Measuring SARS-CoV-2-Specific T-Cell Responses in an Ongoing Pandemic. Pathogens, 12.","DOI":"10.3390\/pathogens12070862"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/8\/881\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:29:17Z","timestamp":1760110157000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/12\/8\/881"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,2]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["vaccines12080881"],"URL":"https:\/\/doi.org\/10.3390\/vaccines12080881","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2024,8,2]]}}}