Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 31
Filter
1.
Indian Journal of Pharmaceutical Sciences ; 84:109-116, 2022.
Article in English | Web of Science | ID: covidwho-2308537

ABSTRACT

Our retrospective study aimed to evaluate the effectiveness of monoclonal antibodies (casirivimab and imdevimab) on mild cases of coronavirus disease 2019 patients admitted to the tertiary care center. A total of 161 patients were evaluated of which the test group consisted of 79 and the control group of 82. In the test group the patients had been administered with diluted 250 ml of 0.9 % sodium chloride along with co-formulated casirivimab (600 mg) and imdevimab (600 mg) solution intravenously and in the control group the patients were administered standard coronavirus disease 2019 treatment protocol. The monitoring of patients in both groups was done at least 1 h after drug infusion in the designated room. Post-treatment designed interviews were taken to evaluate the effectiveness of treatment. This retrospective analysis discovered a significant association of symptoms with the group at 48 h for injected and non-injected patients and 1 mo from the chi-square test after injecting monoclonal antibodies. There is no significant association of symptoms with the groups at 3 mo. A significant difference in the symptom distribution through different time points in the injected group and not injected group was observed. From the pairwise McNemar's test, a significant difference in the symptoms between each time in 48 h, the difference was p=0.0075 and after 1 mo, p<0.001 points in both groups. The combination of casirivimab and imdevimab could be considered a treatment of choice for vaccinated, non-vaccinated and mild to highrisk coronavirus disease 2019 patients.

2.
Global Business and Organizational Excellence ; 2023.
Article in English | Scopus | ID: covidwho-2270340

ABSTRACT

This research aims to study the effectiveness of online teaching, from student and faculty perspectives, during the Covid-19 Pandemic in higher education institutions across India. Using the Student's Evaluation of Online Teaching Effectiveness (SEOTE) scale, a survey was conducted among 1042 students in different Indian universities. The scale measured student faculty contact (SFC), cooperation among students (CAS), active learning (AL), prompt feedback (PF), time on task (TT), high expectations (HE), and diverse talents and ways of learning (DTWL). The research instrument also included three open-ended questions. The quantitative data were analyzed using descriptive statistics and Human Development Index (HDI). The Online Teaching Effectiveness Index (OTEI) value was moderate at 0.62. Challenging aspects of online education were found to be access, learning experience, technology, resources, and infrastructure, the need for face-to-face interaction, and the health hazards of long screen time. The survey of 60 faculty members recorded online teaching to be sustainable, backed by institute support, flexible, and creates the possibility of peer learning. Lack of training resources, unsuitability of course design and practical courses for online mode, and the need for an overhaul of pedagogy were the challenges. Policymakers and digital companies should include infrastructural changes and investments at both the institutional and digital platforms level. © 2023 The Authors. Global Business and Organizational Excellence published by Wiley Periodicals LLC.

3.
Coronaviruses ; 2(4):415-418, 2021.
Article in English | EMBASE | ID: covidwho-2285242

ABSTRACT

Background: COVID-19 has been declared as a pandemic recently and has caused many deaths worldwide. Till date, no effective drug or vaccine is available against SARS-CoV-2. There is an urgent need to find effective alternative preventive and treatment strategies to deal with the SARS-CoV-2 outbreak. Objective(s): This communication proposes a new potential drug combination (repurposed) for prophylaxis and treatment of SARS-CoV-2. Methods and Materials: We performed a brief review of literature on a combination of Hydroxychloro-quine, Melatonin and Mercaptopurine for prophylaxis and treatment of Novel COVID-19 infection and also assessed their possible mechanism of action against SARS-CoV-2. Observation: Proposed combination seems to be safe, and the target is unlikely to develop resistance to this combination. Conclusion(s): This scientific review proposes potential candidate repurposed drugs and potential drug combinations targeting 2019-nCoV/SARS-CoV-2.Copyright © 2021 Bentham Science Publishers.

5.
10th SAE India International Mobility Conference, SIIMC 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2144318

ABSTRACT

Currently, the Aviation industry uses traditional methods of communication, coordination, & human interaction to give disposition to resolve any kind of nonconformance occurrences which occur during manufacturing or operation of commercial or defense products. This involves increased in-person interaction and additional travel, especially to address the nonconformance issues arising at supplier plants or airports around the globe. During Covid and post-Covid environments, human interactions for the transfer of detailed information at different & distant manufacturing plant locations has been difficult, since support engineering teams (Example: Liaison, Product Review, Quality, Supplier Quality, and Manufacturing Engineering, and/or Service Engineering) have been working remotely. Thus, it has been challenging to coordinate with support engineers to get correct dispositions in short timeframes with no additional cost of quality, thereby creating non-value-added time which delayed the release & execution of the respective rework orders. Mixed Reality (MR) based remote assistance can enable delivery of large amount of complex information, knowledge in a cost-effective way. It helps to simulate and visualize various nonconformance scenarios faced in manufacturing unit which can be viewed and worked on without geographic boundaries. Thus, the members of the Engineering, Operations, and Quality team can unite under one platform to gain a better understanding of the nonconformance issue and deliver more informed decision. This quick decision making not only reduces manufacturing lead time and cost of quality for respective plants but also optimizes product delivery and shipment time of the overall supply chain and reduction of Aircraft on Ground (AOG) time for aircraft in service. In this work, we will demonstrate benefits and applications of MR based remote assistance with various cases which will help in taking accurate, realistic dispositions & enable resolutions on any nonconformance resulting in optimized cost of quality in minimum timeframe © 2022 Boeing.

6.
Gastroenterology ; 162(7):S-599, 2022.
Article in English | EMBASE | ID: covidwho-1967345

ABSTRACT

Background Coronavirus disease 2019 (COVID-19) can increase the risk of thrombosis, cardiovascular events, and kidney injury, but risks among patients with inflammatory bowel disease (IBD) remain unknown. We aimed to characterize risk for these complications among patients with IBD who developed COVID-19. Methods We analyzed complications of COVID-19 in patients reported to the Surveillance Epidemiology of Coronavirus Under Research Exclusion in Inflammatory Bowel Disease (SECURE-IBD) database prior to November 15, 2021. Our primary outcome was a composite of thrombotic complications (peripheral venous thrombosis, pulmonary embolism, thrombotic stroke, and peripheral arterial thrombosis), cardiovascular complications (new arrhythmia, heart failure, myocarditis/pericarditis, and vasculitis), and renal complications (acute kidney injury). Covariates included cardiovascular disease (including stroke), cardiovascular risk factors (diabetes mellitus, hypertension, or smoking), pulmonary disease (asthma, chronic obstructive pulmonary disease, or other chronic lung disease), thrombotic risk conditions (cancer), chronic kidney disease, chronic liver disease, “other” comorbidities, and COVID-19 vaccination with at least one dose. Multivariable analyses assessed the independent effect of variables significant in univariate analyses. Results Among 4,923 patients reported to SECURE-IBD, 79 (1.6%) had thrombotic, cardiovascular, and/or renal complications. There were 45 (0.9%) reports of acute kidney injury, 24 (0.5%) of arrythmias, 8 (0.2%) of peripheral venous thrombosis, 5 (0.1%) each of heart failure, myocarditis/pericarditis, and pulmonary embolism, and 1 (0.02%) each of vasculitis, peripheral atrial thrombosis, and thrombotic stroke. In univariate analyses, complications were more common in patients who were older (p < 0.01), black (p < 0.01), and on corticosteroids (p < 0.01) (Table 1). Patients with severe IBD were more likely to have complications than patients in remission (p < 0.01), as were those with more comorbidities (p < 0.01). Cardiovascular disease, cardiovascular risk factors, pulmonary disease, and chronic renal disease were associated with increased risk (p < 0.01 each). There was no association with vaccination status (p = 1). In multivariate analyses, age (aOR 1.04 [1.03, 1.06]), black race (aOR 4.02 [1.53, 10.55]), severe IBD (aOR 3.21 [1.31, 7.86]), corticosteroid use (aOR 3.63 [1.85, 7.12]), and one (aOR 2.33 [1.10, 4.91]), two (aOR 4.24 [1.42, 12.65]), and three or more (aOR 13.36 [3.48, 51.32]) comorbidities were significant predictors of complications (Table 2). Discussion Thrombotic, cardiovascular, and renal complications from COVID-19 were uncommon among patients with IBD. Patients with older age, black race, corticosteroid use, severe IBD, and greater number of comorbidities may require closer monitoring if they develop COVID-19. (Table Presented)

7.
Gastroenterology ; 162(7):S-593, 2022.
Article in English | EMBASE | ID: covidwho-1967335

ABSTRACT

Background: Several SARS-CoV-2 vaccines are highly effective in preventing most infections, serious disease, hospitalization, and death from COVID-19 in the general population, but data regarding their use and efficacy in patients with inflammatory bowel disease (IBD) are limited. In this study we assessed the use patterns and efficacy of SARS-CoV-2 vaccines in patients with IBD. Methods: We established a multicenter matched case-control cohort of patients with IBD [Crohn's disease (CD), ulcerative colitis (UC)] and COVID-19 between February 2020 and December 2020 for the Surveillance of COVID-19 Impact on Long- Term Outcomes in IBD (SCOUT IBD) study. Cases were defined by the presence of COVID- 19-related symptoms and confirmatory SARS-CoV-2 PCR or IgG testing and non-COVID controls were defined as absence of symptoms and both a negative PCR and IgG in 2020. Cases were matched 1:1 to controls based on age, sex and IBD type. Data were collected on vaccine administration in 2021 and incidence of interval COVID-19 (defined as above) between January and September 2021. Results: The total cohort included 502 patients with IBD [UC (n=222, 44%), CD (n=278, 55%), IBD-undefined (n=2, 1%)] of whom 251 had a history of COVID-19 in 2020. The overall vaccination rate was 61% (n=306) with 189 (62%) patients receiving Pfizer-BioNTech, 101 (33%) Moderna, and 12 (4%) Johnson & Johnson. Vaccinated patients were more likely to be older (P=0.02), female (P=0.07), have a co-morbidity (cardiovascular, respiratory, renal) (P=0.04), or currently be on a biologic (P=0.01), and less likely to have had prior COVID-19 (P<0.001) than patients who did not get vaccinated (Table 1). The overall incidence of interval COVID-19 was 1.6% (N=8), with an infection rate of 0.3% (1/311) in vaccinated patients vs. 3.7% (7/184) in unvaccinated patients (P<0.01). Of infections occurring in unvaccinated patients, 1/7 (14.2%) was severe and required hospitalization requiring ICU admission, and the breakthrough infection in the vaccinated patient was mild and self-limited. COVID-19 reinfection occurred in one patient (0.4%) with prior COVID-19 who was unvaccinated. Under multivariable logistic regression, COVID-19 vaccination (aOR 0.05, 95% CI 0.01-0.41) and prior COVID-19 infection (OR 0.07, 95% CI 0.01-0.63) were highly protective against interval COVID-19. Conclusion: COVID-19 vaccines are effective in patients with IBD and markedly reduce the incidence of COVID-19. Prior COVID-19 is also protective against subsequent infection, although re-infections may occur at a very low rate. These results reaffirm the importance of COVID-19 vaccination in patients with IBD.(Table Presented)(Table Presented)

8.
Gastroenterology ; 162(7):S-592-S-593, 2022.
Article in English | EMBASE | ID: covidwho-1967334

ABSTRACT

Background: Inflammatory bowel disease (IBD) and IBD-related biologic therapies are not associated with worse outcomes of Coronavirus Disease 2019 (COVID-19), however, data are lacking regarding the long-term impact of COVID-19 and its inflammatory sequelae on the disease course of IBD. We aimed to investigate the long-term outcomes of patients with IBD and COVID-19. Methods: We performed a multicenter matched case-control study of patients with IBD [Crohn's disease (CD), ulcerative colitis (UC)] and COVID-19 between February 2020 and December 2020 at 5 large health systems. Cases were defined by the presence of COVID-19-related symptoms and confirmatory SARS-CoV-2 PCR or IgG testing. Non-COVID controls were defined as absence of symptoms and both a negative PCR and IgG during the study entry period. Cases were matched 1:1 to controls based on age, sex and IBD type. The primary composite outcome was IBD-related hospitalization or surgery, and outcomes were sub-stratified by COVID-19 severity. Results: We identified 251 cases with IBD [UC (n=111, 44%), CD (n=139, 55%)] and confirmed COVID-19, matched with 251 non-COVID-19 IBD controls, with a median follow-up of 394 days. COVID-19 patients had higher rates of prior IBD-related hospitalizations (36% vs. 27%;P=0.03), corticosteroid use (75% vs. 65%;P=0.06), and biologic exposure (73% vs. 64%;P=0.04) than controls. There were no differences in UC extent or CD phenotype between groups. In COVID-19 positive patients, the most common symptoms were fever (61%), cough (48%), fatigue (30%) and diarrhea (28%). Severe COVID-19 (defined as hospitalization, ICU requirement or mechanical ventilation) occurred in 16% (n=39) of cases. The primary composite outcome of IBD-related hospitalization or surgery occurred in 12% (n=38) of cases vs. 15% (n=29) of controls (P=0.24;Table 1). When further stratified by COVID-19 severity, the incidence of the primary composite outcome was highest in patients with severe COVID-19, followed by controls and non-severe COVID-19 (Figure 1). Under multivariate Cox regression, severe COVID-19 remained a predictor of worse IBD outcomes (aHR 2.09, 95% CI 0.91-4.86) whereas non-severe COVID-19 was associated with decreased risk (aHR 0.52, 95% CI 0.28- 0.99). Prior IBD-related hospitalization or surgery (aHR 3.10, 95% CI 1.70-6.57) and current steroid use (aHR 2.17, 95% CI 0.95-4.94) were also predictive of worse IBD outcomes. Conclusion: In this matched case-control study, a history of any COVID-19 infection did not appear to exacerbate the course of IBD, however, severe COVID-19 was associated with worse IBD outcomes. These data suggest that the inflammatory sequelae of COVID-19 may adversely impact the subsequent disease course of IBD. Further studies are required to confirm these associations, which underscore the importance of COVID-19 mitigation measures.(Table Presented) (Figure Presented)

9.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(7):907-915, 2022.
Article in English | EMBASE | ID: covidwho-1928809

ABSTRACT

In 2019, a new variant of coronavirus emerged that put the whole world on a standstill due to its unprecedented spread and morbidity. Since then, scientists have been working on several theories to explain the origin and pathogenesis of the virus. Over this period of time, it has been observed clinically that individual variation exists in the way this virus infects people, its symptomatology and sequelae. The pathophysiology is still unclear. This review was taken up to consolidate all the available information until date about current theories of etiopathogenesis with an understanding of potential therapeutic targets on the mechanisms. This review also highlights the gray areas that need to be addressed in the future. Research papers published up to December 7, 2020 were included based on a search on PubMed, Google Scholar, etc., to get the latest relevant literature on this topic. Coronavirus expresses differently in different individuals, affecting different organ systems, and having variable severity. However, the underlying pathogenic mechanisms are not completely understood. Due to the lack of definite curative therapy, it is essential to explore the basic pathophysiology so as to develop more effective and target-based therapies in the future.

10.
60th IEEE Conference on Decision and Control (CDC) ; : 3531-3531, 2021.
Article in English | Web of Science | ID: covidwho-1868523
12.
Open Forum Infectious Diseases ; 8(SUPPL 1):S320, 2021.
Article in English | EMBASE | ID: covidwho-1746559

ABSTRACT

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an infection with widely varying clinical severity. Severe COVID-19 was initially proposed to be secondary to cytokine storm syndrome (CSS). However, studies since showed that patients with severe COVID-19 rarely display CSS cytokine phenotypes, and may have more limited inflammatory responses instead. Methods. Prospective cohorts, aged 0-90 years of age who tested positive by polymerase chain reaction (PCR) for SARS-CoV-2 were enrolled from inpatient hospitals and outpatient testing centers in Memphis, TN from May 2020-January 2021. Longitudinal blood samples were obtained including acute, sub-acute and convalescent timepoints. Severity scores of asymptomatic, mild, moderate, and severe COVID-19 were assigned at time of convalescent assessment. Plasma was analyzed with a quantitative human magnetic 38-plex cytokine assay. Results. : 169 participants were enrolled, including 8 asymptomatic, 117 mild, 22 moderate and 17 severe cases, and 5 children with post-COVID-19 multisystem inflammatory syndrome in children (MIS-C). All moderate and severe patients were hospitalized and received treatment (39%). Clear distinctions were seen between asymptomatic-mild cases and moderate-severe cases at acute timepoints and during disease progression for GCSF, IL-8, IL-10, IL-15, IL-1Ra, IP-10, MIP-1a, MIP-1β, and TGFα. There was a significant difference between participants who did and did not require hospitalization for acute timepoint levels of IL-10, IL-15, MIP-1 β and TGFα (p< 0.01). Only 4 participants with active COVID-19 were found to meet criteria for CSS (2%), only 3 of which were severe. MIS-C participants showed nearly universally elevated cytokine levels compared to those with active COVID-19. Conclusion. Moderate and severe acute COVID-19 has a distinct cytokine profile from asymptomatic and mild cases, as detected from acute, subacute and convalescent plasma.

14.
Journal of Crohn's and Colitis ; 16:i572-i573, 2022.
Article in English | EMBASE | ID: covidwho-1722357

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) tends to cause mild disease in children, although severe disease occurs rarely. Children with inflammatory bowel disease (IBD) often receive immunosuppressive medications that may increase risk of infectious complications. Little is known about the severity of breakthrough infection after COVID-19 vaccination in children with IBD. We describe COVID-19 outcomes among children with IBD, including those with breakthrough infection. Methods: The Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is a database created to evaluate COVID-19 outcomes in IBD patients. We included children (age ≤18) from the SECURE-IBD database through November 17th, 2021. We used descriptive statistics to summarize demographic/disease characteristics of the study population, both overall and stratified by hospitalization status, and performed bivariate comparisons. We reported demographic and clinical details of patients requiring an intensive care unit stay and those with breakthrough infection (defined as ≥1 COVID-19 vaccination prior to infection), respectively. Results: We analyzed 606 pediatric IBD COVID-19 cases from 37 countries. The most common IBD medications were tumor necrosis factor (TNF) antagonist monotherapy (48%) and sulfasalazine/ mesalamine (20%). Most patients (85%) had no non-IBD comorbidities. No patients died, and 28 children (5%) were hospitalized. Factors associated with hospitalization included non-IBD comorbid conditions (43% hospitalized vs 13% not;p <0.01), moderate/severe IBD disease activity (61% vs 15%;p <0.01 overall), gastrointestinal symptoms (68% vs 16%, p <0.01), and steroid use (29% vs 6%, p <0.01). TNF antagonist monotherapy was associated with a decreased likelihood of hospitalization (29% vs 49%;p value 0.03) (Table 1). Seven patients needed intensive care, and three (0.5%) required mechanical ventilation (Table 2). There were nine fully vaccinated and five partially vaccinated patients who developed breakthrough infection, of whom only one required hospitalization but did not need a ventilator (Table 3). The majority of patients with breakthrough infection (13/14) were on systemic immunosuppressants at the time of COVID-19 infection (10/14 on TNF antagonists). Conclusion: We found that children with IBD have a relatively low risk of severe COVID-19 outcomes. Among children with IBD who developed COVID-19 after vaccination, the majority were on immunosuppressants and had mild disease that did not require hospitalization. These data may reassure families and providers of children with IBD during the COVID-19 pandemic and support public health recommendations for COVID-19 vaccination among eligible children with IBD.

15.
Gastroenterology ; 160(6):S-332-S-333, 2021.
Article in English | EMBASE | ID: covidwho-1598866

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) can cause gastrointestinal (GI) symp-toms, which may be associated with improved outcomes. There are limited data on COVID-19 and GI symptoms among inflammatory bowel disease (IBD) patients. We aimed to describe new GI symptoms and their association with clinical outcomes in IBD patients with COVID-19.Methods: We utilized data from the Surveillance of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD), an international, collaborative registry of IBD patients with confirmed COVID-19. Any new GI symptoms during the time of COVID-19 infection were recorded. We performed descriptive statistics and bivariate analyses to characterize patients with and without new GI symptoms. We also performed a sensitivity analysis of new GI symptoms comparing patients in remission versus those not in remission by physician global assessment. Multivariable logistic regression assessed independent associ-ation of any new GI symptoms with the odds of death due to COVID-19 adjusting for age, sex, race, number of comorbidities, baseline corticosteroid use, and tumor necrosis factor (TNF) antagonist use.Results: Of 2,917 IBD patients with COVID-19, 764 (26.2%) experienced new GI symptoms. The most commonly reported new GI symptom was diarrhea (Table 1). IBD was noted to be in remission in 382 (50%) patients at time of COVID-19 infection. New GI symptoms were common (23.3%) among IBD patients in remission though were more frequently observed in patients with active disease (29.4%). Patients with new GI symptoms were more likely to be older, female, have active disease, of Asian race, and have at least one co-morbidity (Table 2). Patients on any medication, in particular TNF antagonist monotherapy, were less likely to report new GI symptoms. On bivariate analyses, IBD patients with new GI symptoms were more likely to be hospitalized (31.4% vs. 19.2%, p<0.001) but were not more likely to require intensive care/ventilator (5.8% vs. 4.6%, p=0.18) or die due to COVID-19 (2.0% vs 2.5%, p=0.39). On multivariable analysis, new GI symptoms were not significanlty associated with risk of death due to COVID-19 (adjusted OR 0.72, 95% CI 0.38-1.36).Conclusion: New GI symptoms are common among IBD patients with COVID-19. Diarrhea was the most predominant symptom. Patients in remission and those with active disease both frequently reported new GI symptoms. While IBD patients with new GI symptoms were more likely to be hospitalized, they were not more likely to die due to COVID-19.(Table Presented)Table 1. Description of Gastrointestinal (GI) Symptoms Among IBD Patients with COVID-19. New GI symptoms reported among all patients and stratified by disease activity at time of COVID-19 infection.(Table Presented)

16.
Gastroenterology ; 160(6):S-329-S-330, 2021.
Article in English | EMBASE | ID: covidwho-1598320

ABSTRACT

Background: Risk calculators can be an important tool for enabling shared decision making between patients and their health care providers. Demographics, comorbidities, medication use, geographic region, and other factors may increase the risk for complications from COVID-patients with inflammatory bowel disease (IBD). We developed a prognostic risk prediction tool for estimating the probability of hospitalization, intensive care unit (ICU) admission, and death due to COVID-19 in patients with IBD. Methods: Based on reports to Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) from March to October 2020, we modeled the probability of Hospitalization+ (a composite outcome of hospitalization, ICU and/or death), ICU+ (a composite outcome of ICU admission, intubation, and/or death) and Death separately using the Least Absolute Shrinkage and Selection set consisting of a random sample of cases reported between March 2020 and a pre-set cutoff date. Model validation was conducted using a test data set consisting of the remaining cases not in the training data plus all additional cases from one month past the cutoff date. We assessed the resulting models' discrimination using the area under the curve (AUC) of the receiver-operator characteristic (ROC) curves and corresponding 95% confidence intervals. Results: Overall, 2709 cases from 59 countries were included (mean age 41.3 years (s.d. 633 (24%) were hospitalized, 137 (5%) were admitted to ICU or intubated, and 69 (3%) died. The models have excellent discrimination, with an AUC and associated 95% confidence interval estimated on the test data set of 0.79 (0.75, 0.83) for Hospitalization+, 0.88 (0.82, 0.95) for ICU+, and 0.95 (0.91, 0.99) for Death. Age, comorbidities, corticosteroid use, and male sex were associated with higher risk of death while use of biologic therapies was associated with a lower risk of death (Figure 1). The online risk calculator is free and publicly available at https://covidibd.org/covid-19-riskcalculator/ for health care providers to facilitate discussion of the risk from COVID-19 with their IBD patients (Figure 2). After the physician inputs patient information, the prediction tool numerically and visually summarizes the patient’s probabilities of adverse outcomes intervals. Conclusion: Prognostic models can effectively predict who is at higher risk for COVID-19-related adverse outcomes in a population of IBD patients. The risk calculator could provide a basis for distinguishing between high and low-risk patients to aid in personalizing clinical guidance.

17.
Gastroenterology ; 160(6):S-332, 2021.
Article in English | EMBASE | ID: covidwho-1596783

ABSTRACT

Background: Comorbidities Increase The Risk Covid-19 Morbidity And Mortality. As Comorbidities Are Common In Patients With Inflammatory Bowel Diseases (Ibd), We Sought To Evaluate The Effect Of Comorbidities On Covid-19 Outcomes Among Ibd Patients. Methods: Data Were Obtained From Surveillance Epidemiology Of Coronavirus Under Research Exclusion For Inflammatory Bowel Disease (Secure-Ibd), An International Registry To Determine Characteristics And Outcomes Of Covid-19 In Ibd Patients. We Used Multivariable Regression To Analyze Associations Between Eleven Non-Ibd Comorbidities And Covid-19-Related Hospitalization Or Death. We First Modeled Each Comorbidity Individually, Adjusting Potential Confounders Such As Age, Gender, Race, Ethnicity And Medication Use. Then, To Determine The Independent Effects Of Each Comorbidity, We Fit A Model Including All Comorbidities As Covariates. Results: 2,035 Patients From 58 Countries Were Included (Mean Age Was 42.7 Years, 50.6% Male). A Total Of 538 Patients (26.4%) Experienced Covid-19-Related Hospitalization Or Death. Of Eleven Comorbidities Analyzed, All But A History Of Stroke And Obesity Were Associated With Hospitalization Or Death In Our Initial Analysis, With Adjusted Odds Ratio (Aor) Ranging From 1.9 (Asthma And Cardiovascular Disease) To 3.7 (Chronic Kidney Disease). After Adjusting For Age, Sex, Medications, And Comorbidites Found To Significantly Influence Severe Covid-19 In The Initial Analysis, The Independent Associations For Most Comorbidities Remained Significant And Were Strongest For Chronic Kidney Disease (Aor 3.02, 95% Ci 1.45-6.31) And Chronic Obstructive Pulmonary Disease (Copd) (Aor 2.92, 95% Ci 1.32-6.48) (Table 1). Conclusion: Comorbidities Are Associated With Covid-19 Hospitalization And Death Among Ibd Patients. These Data Can Be Used To Risk-Stratify Ibd Patients And Guide Treatment And Lifestyle Decisions During The Ongoing Pandemic. (Table Presented) Independent Effects Of Individual Comorbidities On The Risk Of Hospitalization Or Death From Covid-19 In Patients With Inflammatory Bowel Diseases

18.
Gastroenterology ; 160(6):S-525, 2021.
Article in English | EMBASE | ID: covidwho-1594630

ABSTRACT

Background: Cases of Coronavirus disease 2019 (COVID-19) have emerged in discrete waves across different regions in the world. We explored temporal trends in the reporting of COVID-19 in patients with inflammatory bowel disease (IBD), in a large global database. Methods: The Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) is an international registry to study the character-istics and outcomes of patients with IBD diagnosed with COVID-19. Joinpoint regression models calculated the average percent change (APC) with 95% confidence intervals (CI) in weekly reported cases of COVID-19 in patients in the registry stratified by geographic regions (Asia, Europe, Latin America, and North America) during two time periods: March 22 to September 12 and September 13 to November 14, 2020. We also determined the APC in US regions (Midwest, Northeast, South and West) during the two time periods. Results: Across 63 countries and dependencies, 3,195 cases of COVID-19 in people with IBD were reported over an 8-month period. Overall, COVID-19 reporting steadily decreased throughout the world by 4.5% per week (95% CI: −5.7, −3.2) from March 22 to September 12, 2020 but then steadily climbed by 12.4% per week (95% CI: 6.8, 18.3) from September 13 to November 14, 2020. After stratification by geographic region, weekly reporting declined before September 13 in North America (APC = −2.0%;95% CI: −3.7, −0.4), Asia (APC =− 4.4%;95% CI: −7.8, −0.9), and Europe (APC = −8.6%;95% CI: −10.6, −6.6), but escalated in Latin America (APC = 3.4%;95% CI: 0.7, 6.1) (Figure 1). After September 12, the rate of weekly cases decreased in Latin America (APC = −19.0%;95% CI: −33.3, −1.7) and Asia (APC = −19.3%;95% CI: −34.6, −0.5), while increased in North America (APC = 10.7%;95% CI: 4.3, 17.4) and Europe (APC = 28.0%;95% CI: 17.3, 39.6) (Figure 1). Within the US, temporal trends differed by region: Midwest (stable APC: −0.8%;95% CI: −3.5, 1.9 then increase APC: 27.3%;95%: 16.1, 39.6), Northeast (decrease APC: −9.1%;95% CI:− 11.8, −6.2 then stable APC: 2.4%;95% CI: −9.9, 16.5), South (increase APC: 5.3%;95%CI: 2.5, 8.3 then decrease APC: −12.0;95% CI: −18.4, −5.0), and West (stable APC: 0.2%;95% CI: −3.0, 3.5 then stable APC: 9.0%;95% CI: −13.8, 37.9) (Figure 2). Conclusion: COVID-19 reporting to SECURE-IBD declined steadily during the first wave of the pandemic throughout the world except Latin America. Starting in September, reports to SECURE-IBD rose in both Europe and North America, consistent with the second wave of the pandemic in these countries.(Figure presented)Figure 1. Global regional temporal trends in reporting of COVID-19 in patients with IBD from the SECURE-IBD registry: A. Asia, B. Europe, C. Latin America, and D. North America: March 22–28 to September 6-12 and September 13-19 to November 8–14, 2020(Figure presented)Figure 2. United States regional temporal trends in reporting of COVID-19 in patients with IBD from the SECURE-IBD registry: A. Midwest, B. Northeast, C. South, and D. West: March 22–28 to September 6-12 and September 13-19 to November 8–14, 2020

19.
Gastroenterology ; 160(6):S-331, 2021.
Article in English | EMBASE | ID: covidwho-1590915

ABSTRACT

Background The impact of immune-modifying therapies on outcomes of the Coronavirus disease 2019 (COVID-19) may vary depending on their mechanism of action. The purpose of this study was to determine the impact of vedolizumab (VDZ), a gut-selective anti-integrin, on COVID-19 outcomes in inflammatory bowel disease (IBD) patients. Methods Utilizing data from the Surveillance of Coronavirus Under Research Exclusion for IBD (SECUREIBD), an international, collaborative registry of IBD patients with confirmed COVID-19, we studied the impact of VDZ use compared to non-use, and VDZ monotherapy compared to anti-tumor necrosis factor (TNF) monotherapy, on hospitalization and severe COVID-19 (intensive care unit stay, mechanical ventilation and/or death) in adult IBD patients using multivariable logistic regression analyses. Backward selection of covariates was performed to obtain parsimonious models. P values #0.05 were considered significant for all analyses. Results Of 2,631 adult patients with confirmed COVID-19 on any IBD medication in the registry as of November 11, 2020, 312 (11.9%) patients were on VDZ of whom 236 (9.0%) were on VDZ monotherapy. A total of 731 (27.8%) patients were on an anti-TNF monotherapy. COVID-19 outcomes were similar for VDZ users versus non-users [adjusted odds ratio (aOR) 0.91, 95% confidence interval (CI) 0.74 to 1.09 for hospitalization and 1.12, 95% CI 0.60 to 2.10 for severe COVID-19, Table]. However, compared to anti-TNF monotherapy, VDZ monotherapy was positively associated with hospitalization and severe COVID-19 (aOR 1.66, 95% CI 1.17 to 2.35 and 4.71, 95% CI 1.65 to 13.45, respectively). Discussion VDZ use, compared to non-use, was not associated with adverse COVID-19 outcomes. However, when compared to anti-TNF monotherapy, VDZ monotherapy was associated with increased risk of hospitalization and ICU requirement/death. These findings suggest the comparable safety of VDZ relative to most other IBD therapies. The observed effect of anti-TNF may be related to improved safety and/or a possible protective effect against more aggressive COVID-19.(Table presented) Table: Multivariable regression analyses with backward selection of covariates for COVID-19 outcomes by medication class from adult cases in the SECURE-IBD registry

20.
Gastroenterology ; 160(6):S-338, 2021.
Article in English | EMBASE | ID: covidwho-1590914

ABSTRACT

Introduction In the United States (US), race and ethnicity impact outcomes of chronic diseases including inflammatory bowel disease (IBD). The aim of this study was to evaluate racial and ethnic disparities in the coronavirus disease 2019 (COVID-19) outcomes among IBD patients and to assess the degree to which observed disparities may be attributed to non-IBD comorbidities. Methods Using data from the Surveillance of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD), an international, collaborative registry of IBD patients with confirmed COVID-19, we used multivariable logistic regression to evaluate associations between race and ethnicity and COVID-19 outcomes. These included hospitalization and severe COVID-19 defined as a composite of intensive care unit stay, mechanical ventilation and/or death. Results We analyzed 988 US cases (96 [9.7%] Hispanic;141 [14.3%] non-Hispanic Black;680 [68.8%] non-Hispanic White). Bivariate analyses of outcomes are reported in the Table. Compared to non-Hispanic White patients, Hispanic patients had higher odds of hospitalization [adjusted odds ratio (aOR) 2.01, 95% CI 1.07 to 3.79] but not severe COVID-19 (2.75, 95% CI 0.93 to 8.10). Compared to non-Hispanic White patients, non-Hispanic Black patients had higher odds of hospitalizations (aOR 2.47, 95% CI 1.48 to 4.11) and severe COVID-19 (2.50, 95% CI 1.01 to 6.20) after adjusting for age, sex, and IBD activity (Figure). Upon adjusting for comorbidities, the odds of hospitalization and severe COVID-19 remained unchanged in Hispanic individuals compared to non-White Hispanic individuals (aOR 2.14, 95% CI 1.09 to 4.18 for hospitalizations and 2.69, 95% CI 0.77 to 9.38 for severe COVID-19), but decreased in Black individuals compared to non-White Hispanic individuals (aOR 2.21, 95% CI 1.30 to 3.76 for hospitalization and 2.13, 95% CI 0.81 to 5.59 for severe COVID-19). Conclusions The odds of adverse COVID-19 outcomes are higher in Hispanic and non-Hispanic Black, compared with non-Hispanic White individuals with IBD, accounted for partially by underlying comorbidities. (Table presented) COVID-19 Outcomes for United States cases reported to SECURE-IBD, overall and stratified by race/ethnicity (Figure presented) Odds ratios of A) hospitalization due to COVID-19 and B) severe COVID-19 outcomes (ICU stay, mechanical ventilation or death) among Hispanic vs. non-Hispanic White individuals and among non-Hispanic Black vs. non-Hispanic White individuals

SELECTION OF CITATIONS
SEARCH DETAIL