Incidence, Clinical Characteristics, and Evolution of SARS-CoV-2 Infection in Patients With Inflammatory Bowel Disease: A Single-Center Study in Madrid, Spain.
Adult
Biological Therapy
/ methods
COVID-19
/ epidemiology
Cross-Sectional Studies
Dyspnea
/ etiology
Female
Humans
Hydroxychloroquine
/ therapeutic use
Immunologic Factors
/ therapeutic use
Incidence
Inflammatory Bowel Diseases
/ drug therapy
Logistic Models
Male
Middle Aged
Risk Factors
Spain
/ epidemiology
COVID-19 Drug Treatment
COVID-19
SARS-CoV-2
immunosuppression
incidence
inflammatory bowel disease
Journal
Inflammatory bowel diseases
ISSN: 1536-4844
Titre abrégé: Inflamm Bowel Dis
Pays: England
ID NLM: 9508162
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
received:
19
06
2020
pubmed:
25
8
2020
medline:
30
12
2020
entrez:
25
8
2020
Statut:
ppublish
Résumé
There are scarce data about SARS-CoV-2 infection in patients with inflammatory bowel disease (IBD). Our aim was to analyze the incidence, clinical presentation, and severity of SARS-CoV-2 infection in patients with IBD. This is a cross-sectional, observational study. We contacted all the patients being treated at our IBD unit to identify those patients with suspected or confirmed SARS-CoV-2 infection, following the World Health Organization case definition. Data were obtained by patient electronical medical records and by phone interview. Eighty-two of 805 patients with IBD (10.2%; 95% confidence interval [CI], 8.3-12.5) were diagnosed as having confirmed (28 patients, 3.5%; 95% CI, 2.4-5.0) or suspected (54 patients, 6.7%) infection. Patient age was 46 ± 14 years, 44 patients were female (53.7%), 17.3% were smokers, 51.2% had Crohn disease (CD), and 39.0% had comorbidities. Digestive symptoms were reported in 41 patients (50.0%), with diarrhea as the most common (42.7%). One patient (1.2%) was diagnosed with IBD flare-up during SARS-CoV-2 infection. Twenty-two patients (26.8%) temporarily withdrew from their IBD treatment because of COVID-19. Most of the patients had mild disease (79.3%), and 1 patient died (1.2%). In the multivariate analysis, the presence of dyspnea was associated with moderate to severe infection (odds ratio, 5.3; 95% CI, 1.6-17.7; P = 0.01) and myalgias (odds ratio, 4.8; 95% CI, 1.3-17.9; P = 0.02) were related to a milder clinical course. Immunosuppression was not related to severity. SARS-CoV-2 infection in patients with IBD is not rare. Dyspnea is associated with a more severe infection. Therapy for IBD, including immunomodulators and biologic therapy, is not related to a greater severity of COVID-19, and SARS-CoV-2 infections do not appear to be related to IBD flare-ups.
Sections du résumé
BACKGROUND
There are scarce data about SARS-CoV-2 infection in patients with inflammatory bowel disease (IBD). Our aim was to analyze the incidence, clinical presentation, and severity of SARS-CoV-2 infection in patients with IBD.
METHODS
This is a cross-sectional, observational study. We contacted all the patients being treated at our IBD unit to identify those patients with suspected or confirmed SARS-CoV-2 infection, following the World Health Organization case definition. Data were obtained by patient electronical medical records and by phone interview.
RESULTS
Eighty-two of 805 patients with IBD (10.2%; 95% confidence interval [CI], 8.3-12.5) were diagnosed as having confirmed (28 patients, 3.5%; 95% CI, 2.4-5.0) or suspected (54 patients, 6.7%) infection. Patient age was 46 ± 14 years, 44 patients were female (53.7%), 17.3% were smokers, 51.2% had Crohn disease (CD), and 39.0% had comorbidities. Digestive symptoms were reported in 41 patients (50.0%), with diarrhea as the most common (42.7%). One patient (1.2%) was diagnosed with IBD flare-up during SARS-CoV-2 infection. Twenty-two patients (26.8%) temporarily withdrew from their IBD treatment because of COVID-19. Most of the patients had mild disease (79.3%), and 1 patient died (1.2%). In the multivariate analysis, the presence of dyspnea was associated with moderate to severe infection (odds ratio, 5.3; 95% CI, 1.6-17.7; P = 0.01) and myalgias (odds ratio, 4.8; 95% CI, 1.3-17.9; P = 0.02) were related to a milder clinical course. Immunosuppression was not related to severity.
CONCLUSIONS
SARS-CoV-2 infection in patients with IBD is not rare. Dyspnea is associated with a more severe infection. Therapy for IBD, including immunomodulators and biologic therapy, is not related to a greater severity of COVID-19, and SARS-CoV-2 infections do not appear to be related to IBD flare-ups.
Identifiants
pubmed: 32830267
pii: 5896213
doi: 10.1093/ibd/izaa221
pmc: PMC7499624
doi:
Substances chimiques
Immunologic Factors
0
Hydroxychloroquine
4QWG6N8QKH
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
25-33Informations de copyright
© 2020 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Nature. 2020 Mar;579(7798):270-273
pubmed: 32015507
Autoimmun Rev. 2020 Jul;19(7):102568
pubmed: 32376398
Gut. 2020 Jun;69(6):984-990
pubmed: 32303607
Aliment Pharmacol Ther. 2020 Jul;52(2):276-283
pubmed: 32359205
Expert Rev Gastroenterol Hepatol. 2018 Nov;12(11):1101-1108
pubmed: 30277409
J Crohns Colitis. 2014 Jun;8(6):443-68
pubmed: 24613021
Clin Gastroenterol Hepatol. 2020 Aug;18(9):2143-2146
pubmed: 32380089
Aliment Pharmacol Ther. 2020 May;51(9):843-851
pubmed: 32222988
Gastroenterology. 2020 Jul;159(1):371-372
pubmed: 32247695
Eur J Neurol. 2020 Sep;27(9):e33
pubmed: 32443166
Gastroenterology. 2021 Jan;160(1):473-474
pubmed: 32389663
Gut. 2012 Mar;61(3):385-91
pubmed: 21757451
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Aliment Pharmacol Ther. 2020 Jul;52(1):54-72
pubmed: 32348598
Clin Infect Dis. 2020 Jul 28;71(15):762-768
pubmed: 32161940
Lancet Gastroenterol Hepatol. 2020 Jul;5(7):667-678
pubmed: 32405603
Gut. 2020 Jul;69(7):1213-1217
pubmed: 32354990
Gastroenterology. 2020 Sep;159(3):1141-1144.e2
pubmed: 32387541
Gastroenterology. 2020 May;158(6):1518-1519
pubmed: 32142785
Clin Gastroenterol Hepatol. 2020 Aug;18(9):2134-2135
pubmed: 32360811
Inflamm Bowel Dis. 2012 Jan;18(1):25-33
pubmed: 21472826
Lancet. 2020 Aug 22;396(10250):535-544
pubmed: 32645347
Clin Immunol. 2020 May;214:108393
pubmed: 32222466