Subject(s)
Ambulatory Care/statistics & numerical data , COVID-19 , Gastroenterology , Telemedicine/statistics & numerical data , Telephone/statistics & numerical data , Videoconferencing/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Young AdultSubject(s)
Anti-Inflammatory Agents/administration & dosage , COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , Immunologic Factors/administration & dosage , Inflammatory Bowel Diseases/drug therapy , Janus Kinase Inhibitors/administration & dosage , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Inflammatory Agents/therapeutic use , Antibodies, Monoclonal, Humanized/administration & dosage , Antibodies, Monoclonal, Humanized/therapeutic use , COVID-19/complications , Drug Administration Schedule , Female , Follow-Up Studies , Humans , Immunologic Factors/therapeutic use , Inflammatory Bowel Diseases/complications , Janus Kinase Inhibitors/therapeutic use , Male , Middle Aged , Polymerase Chain Reaction , Retrospective Studies , Time Factors , Time-to-Treatment , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: The effect of immunosuppressive treatment for immune-mediated diseases on risk of the novel coronavirus disease 2019 (COVID-19) has not been established. We aimed to define the effect of targeted biologic and immunomodulator therapy on risk of COVID-19 in a multi-institutional cohort of patients with inflammatory bowel disease (IBD). METHODS: We identified patients 18 years and older who received care for IBD at Partners Healthcare between January 2019 and April 2020. The primary outcome was development of COVID-19 defined as a positive polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2. Multivariable regression models were used to examine the effect of immunosuppression on risk of COVID-19 and its outcomes. RESULTS: In a cohort of 5302 IBD patients, 39 (0.7%) developed COVID-19. There was no difference in age, sex, or race between IBD patients with and without COVID-19. The rate of COVID-19 was similar between patients treated with immunosuppression (0.8%) compared with those who were not (0.64%; P = 0.55). After adjusting for age, sex, race, and comorbidities, use of immunosuppressive therapy was not associated with an increased risk of COVID-19 (odds ratio, 1.73; 95% confidence interval, 0.82-3.63). The presence of obesity was associated with a higher risk of COVID-19 (odds ratio, 8.29; 95% confidence interval, 3.72-18.47). There were 7 hospitalizations, 3 intensive care unit stays, and 1 death. Older age and obesity but not immunosuppressive treatment were associated with severe COVID-19 infection. CONCLUSIONS: The use of systemic immunosuppression was not associated with an increased risk of COVID-19 in a multi-institutional cohort of patients with IBD.