A descriptive study of patients with new onset of inflammatory bowel
disease and exacerbations after ChAdOx1-nCoV-19 and inactivated COVID-19
vaccines in a tertiary hospital of North India
Abstract
Background Flares of inflammatory bowel disease (IBD) and a few
cases of new-onset IBD have been reported after mRNA-based COVID-19
vaccines. Reports are scarce with viral vector and inactivated COVID-19
vaccines. Methods Patients diagnosed with ‘flares’ and
new-onset IBD after receiving ChAdox1-nCoV-19 and inactivated COVID-19
vaccines were recruited from April–July 2022 from the Gastroenterology
department of a tertiary hospital of North India. Clinical presentation,
colonoscopy findings, treatment, and outcomes were recorded.
Results A total of 44 patients were identified. 28 patients had
flares of IBD at a median interval of 8.1, 13.2, and 2 weeks since the
first, second, and booster doses of COVID-19 vaccines respectively. 16
new-onset cases of IBD occurred at a median interval respectively of
4.8, 9, and 17.8 weeks after the first, second, and booster doses. The
majority of the cases occurred after the second dose of ChAdOx1-nCoV-19.
With oral amino-salicylic acid (ASA), ASA enema, and systemic steroids,
improvement was seen in the majority at a median follow-up of 26-30
weeks. 14 patients had persistent health issues (median follow-up of
73-75 weeks). Conclusion New-onset IBD and exacerbations can
occur after 1-3 months of COVID-19 vaccines. Extended surveillance of
vaccinated individuals is required to understand the incidence and
course of late-onset adverse events and molecular studies are warranted
to understand their immunological basis.