ACE2 and congenital secretory chloride diarrhea 1: In contrast, anti-TNF-treated patients with IBD, known to have impaired vaccine immunogenicity [23,24,31,33,34], had reduced inhibition of ACE2 binding by all tested SARS-CoV-2 lineages compared to patients with CLD (each p ≤ 0.048; Figure S4).