ABSTRACT
Background: The impact of COVID-19 infection on patients with eosinophilic esophagitis (EoE) and other eosinophilic GI diseases (EGIDs) is not known. Aim: To determine the characteristics of EoE and EGID patients who have COVID-19, assess severity COVID-19 in the EGID population, and evaluate for COVID-19-induced EGID flares. Methods: We established an online global registry (covideoeegid.org) where health care providers could report details of COVID-19 infection in EoE and EGID patients. The registry was publicized and reminders were sent via worldwide patient advocacy groups, professional organizations, and research collaborative groups. De-identified data were entered into the website related to patient demographics, EGID disease features and activity, comorbidities, and treatments. Data collected related to COVID-19 included source of exposure, symptoms, illness severity, hospitalizations, and deaths. Descriptive statistics were used to summarize the findings. Results: A total of 40 cases of COVID-19 in EoE/EGID patients were reported as of November, 2020 (Figure). Patients had a mean age of 25 (±11) years at the time of COVID-19 diagnosis, the majority were male (73%) and had atopy (73%), and nearly all (95%) had EoE, though some non-EoE EGIDs were reported (Table). At the time of COVID-19 infection, EGID disease activity was reported as in remission in 18 (45%) and moderate in 13 (33%). EGID treatments at the time of COVID-19 included PPIs (58%), swallowed/topical steroids (45%), and/or dietary elimination (42%) (Table). Most common exposures for COVID-19 were either unknown (30%) or from household contacts (30%);34 of the reported cases were confirmed with testing, while 6 were suspected based on clinical presentation. Common symptoms included cough (63%), fever (50%), anosmia (20%), and ageusia (18%);15% of cases were asymptomatic. No COVID-19 infections were classified as severe, and 32 (80%) were deemed mild (Table). Only 1 patient was hospitalized (received lopinavir and hydroxychloroquine), and no ICU admissions or deaths were reported. The mean number of days from infection to symptom resolution was 9.8±8.3. No EGID disease activity flares were reported due to COVID-19. Conclusions: In a global EoE/EGID registry, relatively few COVID-19 cases have been reported over an initial 8 month period, despite extensive efforts at outreach. The reported cases of EGID/COVID-19 are mild, with only one hospitalization and no deaths. Despite concerns of possible reporting bias and that EGID patients tend to be younger, based on this registry it does not appear that EGID patients are at increased risk for severe COVID-19 infection or that COVID-19 leads to EGID flares. Future serologic studies are needed to determine the prevalence of COVID in EGIDs. We ask providers to continue to report cases (covideoeegid.org). (Image presented) (Table presented)