الفهرس 
ULCERATIVE COLITIS (UC)Only 14 pages are availabe for public view
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Abstract
I
nflammatory bowel diseases (IBDs), which includes Crohn’s disease (CD) and ulcerative colitis (UC), are chronic, relapsing-remitting diseases that constitute a growing worldwide health burden.
Coronavirus disease 2019 (COVID-19), the highly contagious viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a catastrophic effect on the world’s demographics resulting in more than 6 million deaths worldwide. It has been considered as the most consequential global health crisis since the era of the influenza pandemic of 1918.
COVID-19 virus has been reported to colonize the gastrointestinal tract and cause diarrhea in 31% of patients with COVID-19 pneumonia, even after respiratory symptoms have resolved. This could be related to an autoimmune response via molecular mimicry or via ACE-2 receptor.
The release of an inflammatory cascade is severe enough to either reactivate dormant UC or “generate” a de novo autoimmune response in a genetically predisposed patient.
UC has been proven to have an economic and physical burden upon patients, with an associated mortality of up to 2.9%. However, morbidity and mortality have peaked since the breakout COVID-19 pandemic as result of the direct relationship between IBD severity and adverse outcome from SARS-CoV-2 infection.So efforts to develop a vaccine to prevent the SARS-CoV-2 infection had led to multiple vaccines available.
This study was to evaluate the efficacy and safety of inactivated COVID 19 vaccine (e.g. Sinopharm) in UC patients receiving anti TNF in comparison to normal healthy population receiving the same type of vaccine 3 months after the last dose of vaccination.
This study was conducted on UC patients that visited IBD study group clinic in Tropical Medicine department of Ain Shams University Hospitals from March 2022 till the end of February 2023. Total number of UC patients that visited IBD study group clinic from March 2022 till the end of February 2023 were 130 patients, only 20 Patients (15%) were meeting the inclusion criteria and named as group (A), then compared to control samples of 20 healthy Egyptian adults that have been chosen by simple random method and was named as group (B).
o group A: All patients with confirmed diagnosis of UC based on clinical history, laboratory and endoscopic finding according to ECCO 2017 & 2021 guidelines in remission on anti-TNF and received two doses of inactivated COVID 19 vaccine in centers allocated by the Egyptian ministry of health according to their nearby location of home addresses.
o group B: Control samples from healthy Egyptian subjects; age and sex matched to group (A) and received two doses of inactivated COVID 19 vaccine in centers allocated by the Egyptian ministry of health according to their nearby location of home addresses.
All the patients in the study group (group A) were been subjected to:
1. History taking with special focus on basal demographic data, history of smoking, Lower gastrointestinal, extra-intestinal and respiratory symptoms.
2. Thorough clinical examination: General and local abdominal examination
3. Review of received therapy whether medical or surgical.
4. Assessment of disease severity was done according to Truelove and Witts’ severity index.
5. Anti-spike IgG titre three months after full vaccination by two doses of inactivated COVID 19 vaccine provided by the Egyptian ministry of health.
6. Side effects of vaccine were monitored during receiving two doses of vaccine and throughout 3months post full vaccination.
All the subjects in the control group (group B) were be subjected to:
1. History taking to exclude any disease.
2. Anti-spike IgG titre three months after full vaccination by two doses of inactivated COVID 19 vaccine provided by the Egyptian ministry of health.
3. Side effects of vaccine were monitored during receiving two doses of vaccine and throughout 3months post full vaccination.
Our study revealed that the mean age of UC patients (group A) and control group (group B) was 31.65 (+7) years, 30.55(+5.67) years respectively. There was female predominance with 12 females (60%) and 8 males (40%) in UC patients, while the control group had 11 males (55%) and 9 females (45%) with no significant difference between studied groups regarding age and sex while There was a significant difference between the 2 groups in the smoking which included no one in group A (0%) and 5 persons in group B (25%) with P value =0.047.
Of the 20 patients in group A, only 16 (80%) had positive anti-spike IgG versus 18 positive samples in group B (90%) with no significant statistical difference. As regard anti-spike IgG titre after 3 months, there was a significant statistical difference between the 2 groups with P value=0.025.
With regards to complications from inactivated COVID-19 vaccine between the two studied groups, there was no significant difference between studied groups regarding pain at site of injection, skin allergy and generalized symptoms (fatigue, fever, chills, headache, muscles and joints pain).