Aim There are limited data on the impact of 2 vs 3 doses of COVID-19 vaccine in patients with inflammatory bowel disease (IBD). The primary aim of the study was to assess the efficacy of COVID-19 vaccine based on number of administered doses in patients with IBD. Methods We conducted a retrospective cohort study using TriNetX, a multi-institutional database to compare patients with IBD who received 1, 2, or 3 doses of BNT162b2 or mRNA-1273 to unvaccinated IBD patients (1.1.2020-7.26.2022) to assess the risk of COVID-19 after 1:1 propensity score matching. We also evaluated the impact of vaccine on a composite of severe COVID-19 outcomes including hospitalization, intubation, intensive care unit care, acute kidney injury, or mortality. Results After propensity score matching, vaccinated patients with 2 (adjusted OR [aOR], 0.8; 95% confidence interval [CI], 0.6-0.9) and 3 doses (aOR, 0.7; 95% CI, 0.5-0.9) were found to have a lower risk of COVID-19 compared with unvaccinated patients. Vaccinated patients with IBD had a lower risk of severe COVID-19 outcomes (aOR, 0.7; 95% CI, 0.6-0.9) compared with unvaccinated patients. There was no difference in the risk of COVID-19 in IBD patients with 2 compared with 3 doses (aOR, 0.97; 95% CI, 0.7-1.3). However, IBD patients with 2 doses were at an increased risk for hospitalization due to COVID-19 (aOR, 1.78; 95% CI, 1.02-3.11) compared with those that received 3 doses. Conclusion Vaccinated patients with IBD had a lower risk of severe COVID-19 outcomes compared with unvaccinated patients. A third dose of COVID-19 vaccine compared with 2 doses decreases the risk of hospitalization but not breakthrough infection in patients with IBD.

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Pregnant patients who received nondiagnostic ferritin labs at less than 20 weeks of gestation from 2019 to 2021 were retrospectively identified. Patients were excluded if ferritin testing was conducted for diagnostic purposes or if the patient had a history of anemia. Labs at the time of registration, 28 weeks of gestation, and at delivery were analyzed. Anemia was defined as Hgb less than 11 g/dL. This study was approved by the University of Washington IRB, and patient consent was waived.RESULTS: Forty-four patients underwent routine ferritin screening at registration, with ferritin levels ranging from 10 to 136 ng/mL (average 52.5 ng/mL). Average Hgb/Hct at registration were 12.6 g/dL and 37.3%, respectively. At 28 weeks of gestation, Hgb/Hct were obtained on 42 patients, of whom 9 patients were diagnosed with anemia. Patients diagnosed with anemia had a screening ferritin level of 33.6 ng/mL, and nonanemic patients had a ferritin level of 57.4 ng/mL (P 5.1). When a cutoff of 50 ng/mL was studied to compare patients with "low" versus "normal" ferritin, ferritin less than or equal to 50 ng/ mL had significantly lower Hgb levels at 28 weeks compared to those with ferritin greater than 50 ng/mL (P 5.013). On labor and delivery (L&D), Hgb/Hct was obtained on 44 patients, and 14 were diagnosed with anemia. Anemic patients on L&D had significantly lower screening ferritin compared to nonanemic, 31.9 and 62.2 ng/mL, respectively (P 5.016).CONCLUSION: Ferritin screening in early pregnancy may help predict lower Hgb in later gestation. Using a higher ferritin cutoff of 50 ng/mL in early pregnancy for identifying patients at risk for anemia in the third trimester may be warranted. Larger prospective studies are needed to evaluate further the utility of ferritin screening.

The queried pool of patients was stratified into obese (BMI $ 30), and non-obese cohorts using International Classification of Diseases, Tenth Revision (ICD-10) codes. After performing descriptive analysis on the involved cohorts, linear and multivariate regression was used to evaluate study outcomes. STATA 14 was used for data analysis. Results: Of 142,094 admissions for UC flare, 12,989 (9.14%) had comorbid obesity. Compared to non-obese-UC patients, obese-UC patients were significantly older (51.2 vs 48.5 years, p , 0.0001), were more often female (63.9% vs 53.0%, p , 0.0001), had greater Caucasian and African American representation (73.0% vs 71.5%, p , 0.0001), (13.8% vs 11.3%, p , 0.0001) compared to non-obese patients. Obese-UC patients had more comorbid disease as measured by a Charlson Comorbidity Index score $3 (16.4% vs 9.62, p , 0.0001), and had more patients belonging to the poorest quartile of family income (27.9% vs 23.9%, p, 0.0001). Obese-UC patients as compared to those without obesity had a nonsignificant increase in adjusted odds of inpatient mortality (aOR 1.17; 95% CI 0.67-2.03, p50.583). Obese-UC had higher rates of complications including LGIB (OR 1.79, p 5 0.017), Shock (OR 1.48, p 5 0.017), AKI (OR 1.42, p 5 0.001). Additionally, Obese-UC patients had an increased LOS (5.48 vs 5.18 days, p 5 0.007) and higher THC ($54,194 vs $49,957, p 5 0.005). Conclusion: Obesity did not significantly increase inpatient mortality. However Obese-UC patients had increased complications (LGIB, Shock, AKI), LOS, and THC relative to UC patients without obesity. Additional studies are needed to further investigate the effects of obesity in UC, and to help reduce the economic burden obesity places on the healthcare system.

were most consistent with ulcerative colitis (UC). Ixekizumab was discontinued. Hydrocortisone and mesalamine were started. Shortly thereafter all GI symptoms completely resolved and patient was discharged home. Discussion: Here we present a patient with history of psoriasis, who developed severe UC in the context of recent IL-17 inhibitor use. Clinical trials investigating IL-17 inhibition in inflammatory bowel disease (IBD) suggest that it may cause worsening or relapse in symptoms. We present a unique case of ixekizumab causing new-onset UC. This patient had no family history of IBD, no smoking history, & no extraintestinal manifestations suggestive of UC. Only after introduction of ixekizumab he developed symptoms and pathology related to UC. This case describes rare GI manifestations of ixekizumab and other IL-17 inhibitors. It reminds us to be cognizant and monitor for IBD symptoms in patients taking such medications.[2735] Figure 1. Colonoscopy demonstrated a contiguous area of bleeding ulcerated mucosa in the rectum (1A) and sigmoid colon (1B).