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2.
Journal of Sleep Research Conference: 26th Conference of the European Sleep Research Society Athens Greece ; 31(Supplement 1), 2022.
Article in English | EMBASE | ID: covidwho-2115067

ABSTRACT

Objectives/Introduction: Sleep deprivation and sleep disorders have been related to a reduced or delayed antibody response following vaccination. However, studies in this field have provided inconsistent results, with some failing to show significant effects on antibody titers in these conditions. The possible reasons for the discrepancies on the results rely on methodological variability, including different sleeprelated conditions, diseases and time from vaccination to antibody assessment. This study intended to perform a systematic review and meta-analysis on the effects of sleep deprivation and sleep disorders on antibody response after vaccination. Method(s): Literature searches were performed at PubMed, Scopus and Web of Science, comprising two search domains, one related to sleep and other to vaccination. The records were screened in a twostep process (title and s, follow by full text analysis), by two independent reviewers. Eligibility criteria included individuals with previous diagnosis of a sleep disease or subjected to an experimental sleep deprivation schedule, which have undergone vaccination for a specific disease. The main outcome was the post-vaccinal antibody titers. The effects size for each article was calculated using standardized mean differences and the meta-analyses used the DerSimonian and Laird random effects model. Result(s): Out of 9009 identified records, six were included in the final sample. Among these, four were related to H1N1/influenza, one to hepatitis and one to COVID-19. Three studies evaluated the effects of sleep deprivation, two were related to obstructive sleep apnea and one was related to insomnia. The date since vaccination to antibody measurement varied from five days to one month. The results demonstrated a non-significant reduction in antibody titers due to sleep disorders (SDM: -0.206;CI95%: -0.783 to 0.071;p = 0.144). Conclusion(s): The results demonstrate that sleep disorders and sleep deprivation altogether do not lead into a significant reduction in the antibody titers after vaccination. However, the studies included are subjected to substantial methodological heterogeneity, and it is possible that significant effects would appear in more specific conditions (such as for specific sleep disorders, diseases and time points after vaccination).

3.
Sleep ; 45(Suppl. 1):1, 2022.
Article in English | GIM | ID: covidwho-2077878

ABSTRACT

Introduction: Sleep disorders and sleep deprivation induces decreased antibody response following vaccination for different viral diseases (including H1N1, influenza and hepatitis A). The same has been speculated for COVID-19. This study aimed to assess whether obstructive sleep apnea (OSA) reduces antibody levels after COVID-19 vaccination among older adults.

4.
Annals of the Rheumatic Diseases ; 81:114-115, 2022.
Article in English | EMBASE | ID: covidwho-2008810

ABSTRACT

Background: Patients with rheumatoid arthritis (RA) may have impaired immu-nogenicity to COVID-19 vaccines. Objectives: To investigate the incidence of COVID-19 infection and hospitalisation in unvaccinated and vaccinated patients with RA compared with matched individuals;and secondarily in patients with RA according to DMARD treatment. Methods: Danish nationwide matched cohort study from January to October 2021. Patients with RA were identifed in DANBIO and matched 1:20 with individuals from the general population on age, sex, and vaccination status (month and exact type of vaccination). Primary and secondary outcomes were COVID-19 hospitalisation (Danish National Patient Register) and positive SARS-CoV2 PCR test (Danish COVID-19 Surveillance Register), respectively. Stratifed by vaccination status, incidence rates (IRs) per 1000 person years (PY) and comor-bidity-adjusted hazard ratios (aHRs) in cause-specifc Cox models were calculated with 95% confdence intervals. Using the Aalen-Johansen estimator, the cumulative incidence of COVID-19 hospitalisations was visualised according to RA and vaccine exposure status. Results: Regardless of vaccination status, patients with RA had increased incidence of COVID-19 hospitalisation compared to matched individuals (Table 1). However, the absolute risk was 0.20% for unvaccinated patients at 60 days and 0.08% for comparators, whereas it remained below 0.05% at 180 days of follow-up in both groups when fully vaccinated (Figure 1). Increased SARS-CoV2 infection rates were seen only among unvacci-nated patients with RA (Table 1). Unadjusted analyses showed increased incidence of COVID-19 hospitalisation among rituximab-treated compared with conventional DMARD treated: unvaccinated HR 4.71 (1.98 to 11.18) and vaccinated HR 11.69 (2.07 to 66.06). However, the proportions of patients with previous cancer and treated with prednisolone were higher among the rituximab treated. Conclusion: The incidence of COVID-19 hospitalisation was increased for both unvaccinated and vaccinated patients with RA compared with controls. Importantly, the parallel decreasing risk for patients with RA suggests a comparable relative beneft of vaccination. Less favourable outcomes among rituximab-treated warrant that this drug should be considered with extra care.

6.
Journal of Crohn's & colitis ; 16(Suppl 1):i587-i589, 2022.
Article in English | EuropePMC | ID: covidwho-1998370

ABSTRACT

Background Population-based data regarding outcomes of coronavirus disease 2019 (COVID-19) among patients with ulcerative colitis (UC) and Crohn’s disease (CD) remain limited. Methods We conducted a population-based study investigating the outcomes of COVID-19 among patients with UC and CD in Denmark. The Danish COVID-19 IBD Database is an extensive population-based database which prospectively monitors the disease course of laboratory-confirmed COVID-19 among patients with UC and CD. Severe COVID-19 was defined as COVID-19 necessitating intensive care unit admission, ventilator use, or death, while adverse COVID-19 was defined as requirement of COVID-19 related hospitalization. Regression analysis was adjusted for age, sex, disease type, disease activity, cardiovascular disease, and corticosteroids. Outcomes of COVID-19 among patients with UC and CD were compared with those among the background population covering all incidents of COVID-19 in Denmark. Results The study included 319 patients with UC and 197 patients with CD from January 28th, 2020, to April 1st, 2021. Baseline characteristics are presented in Table 1. A significantly higher risk of COVID-19-related hospitalization was observed among patients with UC (N=46(14.4%), RR=2.49 (95%CI 1.91–3.26)) and CD (N=24(12.2%), RR=2.11 (95%CI 1.45–3.07)) as compared with the background population (N=13,306 (5.8%)). A similar pattern was observed for admission to intensive care (UC: N=8(2.51%), RR=27.88 (95%CI 13.88–56.00);CD: N=3 (1.52%), RR=16.92 (95%CI 5.46–52.46)) (Figure 1). The association between these outcomes and IBD-related clinical characteristics and treatments is presented in Tables 2–3. As shown, none of the IBD-related medications were associated with severe COVID-19 in univariate and multivariable analysis. However, systemic steroids were found to be associated with an increased risk of adverse COVID-19 among patients with CD (adjusted odds ratio (aOR)=13.62 (95% CI 1.98–17.77)). Conclusion This Danish population-based study on COVID-19 outcomes among patients with UC and CD demonstrated severe COVID-19 among only a minority of patients, which was not associated with IBD-related medications. Apart from systemic steroids, this study encourages continued use of IBD therapy to prevent IBD relapse and complications.

7.
Journal of Crohn's & colitis ; 16(Suppl 1):i562-i565, 2022.
Article in English | EuropePMC | ID: covidwho-1998368

ABSTRACT

Background The coronavirus disease 2019 (COVID-19) pandemic raised concerns among patients with ulcerative colitis (UC) and Crohn’s disease (CD) fearing an increased susceptibility to infection and increased risk of poor outcomes. Furthermore, the impact of COVID-19 on subsequent health-related quality of life (HRQoL) has so far not been described. We aimed to evaluate the HRQoL in relation to the severity of COVID-19 in a cohort of survivors. Methods We conducted a population-based study investigating the outcomes of COVID-19 among patients with UC and CD in Denmark. The Danish COVID-19 IBD Database is an extensive population-based database which prospectively monitors the disease course of laboratory-confirmed COVID-19 among patients with UC and CD. Severe COVID-19 was defined as COVID-19 necessitating intensive care unit admission, ventilator use, or death, while adverse COVID-19 was defined as requirement of COVID-19 related hospitalization. HRQoL was assessed using several validated questionnaires, including the EuroQol five-dimension five-level (EQ-5D-5L) questionnaire, EuroQol Visual Analogue Scale (EQ-VAS), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD Disability Index (IBD-DI), and IBD Fatigue Score. Results HRQoL after COVID-19 was assessed among 137/319 (42.9%) patients with UC of whom 125 (91.2%) and 12 (8.8%) patients experienced mild and adverse COVID-19, respectively. Furthermore, HRQoL was assessed among 85/197 (43.1%) patients with CD of whom 74 (87.1%) and 11 (12.9%) patients experienced mild and adverse COVID-19, respectively. HRQoL was assessed after a median of 5.1 months (IQR 4.5–7.9) after infection. Baseline characteristics are presented according to the availability of HRQoL data in Table 1. No difference was observed in terms of EQ-5D-5L among patients with UC and CD or patients with mild, adverse, or severe COVID-19 (Table 2). Accordingly, the SIBDQ scores were similar among patients with mild, adverse or severe COVID-19 and UC (mild: median 59 (IQR 50–65), adverse: 62 (54–65), severe: 62 (54–65), p=0.89) or CD (mild: 57 (46–65), 58 (49–64), 58 (49–64), p=0.91) as well, and no difference was observed in the subscores (Table 2). In line with these results, the IBD Disability Index (UC: median 10 (IQR 6–16), CD: 13 (6–20), p=0.16) were not associated with the severity of COVID-19 (Table 3). Finally, CD patients with adverse COVID-19 experienced more fatigue than patients with mild COVID-19 (26 (IQR 25–35) vs. 41 (IQR 29–46), p=0.03). Conclusion This Danish population-based study found no durable impact of COVID-19 on health-related quality of life among patients with inflammatory bowel disease providing further assurance for the clinical guidelines for IBD care during the pandemic.

8.
BMJ Open ; 12(6), 2022.
Article in English | EMBASE | ID: covidwho-1968299

ABSTRACT

Objective To study the association between behavioural factors and incidence rates of SARS-CoV-2 infection. Design Case-control web-based questionnaire study. Setting Questionnaire data were collected in the Capital Region of Denmark in December 2020 when limited restrictions were in place, while the number of daily SARS-CoV-2 cases increased rapidly. Participants 8913 cases of laboratory-confirmed SARS-CoV-2 infection were compared with two groups of controls: (1) 34 063 individuals with a negative SARS-CoV-2 test from the same date (negative controls, NCs) and 2) 25 989 individuals who had never been tested for a SARS-CoV-2 infection (untested controls, UC). Controls were matched on sex, age, test date and municipality. Exposure Activities during the 14 days prior to being tested positive for SARS-CoV-2 or during the same period for matched controls and precautions taken during the entire pandemic. Main outcomes and measures SARS-CoV-2 infection incidence rate ratios (IRR). Results Response rate was 41.4% (n=93 121). Using public transportation, grocery shopping (IRR: NC: 0.52;UC: 0.63) and outdoor sports activities (NC: 0.75;UC: 0.96) were not associated with increased rate of SARS-CoV-2 infection. Most precautions, for example, using hand sanitizer (NC: 0.79;UC: 0.98), physical distancing (NC: 0.79;UC: 0.82) and avoiding handshakes (NC: 0.74;UC: 0.77), were associated with a lower rate of infection. Activities associated with many close contacts, especially indoors, increased rate of infection. Except for working from home, all types of occupation were linked to increased rate of infection. Conclusions In a community setting with moderate restrictions, activities such as using public transportation and grocery shopping with the relevant precautions were not associated with an increased rate of SARS-CoV-2 infection. Exposures and activities where safety measures are difficult to maintain might be important risk factors for infection. These findings may help public health authorities tailor their strategies for limiting the spread of SARS-CoV-2.

9.
Sleep Science ; 15:29-30, 2022.
Article in English | EMBASE | ID: covidwho-1935358

ABSTRACT

Introduction: Sleep complaints are common in individuals with neurodevelopmental disorders. However, little is known about sleep alterations in children with cri du chat syndrome (CDC) and autism spectrum disorder (ASD) due to the social isolation resulting from the COVID-19 pandemic. Objective: To assess alterations in sleep quality and its associated parameters before and after quarantine resulting from COVID-19, comparing the results between CDC, ASD or neurotypical children. Methods: Sleep was investigated in 53 children with CDC and 106 with ASD using an adaptation of the Brief Infant Sleep Questionnaire (BISQ), assessing sleep patterns both before and during the COVID-19 pandemic. Data were evaluated in comparison to 160 neurotypical (NT) children. Results: Children with CDC and ASD already had higher chances of needing parental assistance to fall asleep, taking more than 30min to fall asleep and having a wake after sleep onset time (WASO) >30min when comparing to neurotypical children in the moment preceding quarantine. Having CDC significantly increased the odds of having awakenings during the night. During quarantine, the proportion of children sleeping in their own bedrooms had decreased and the odds of awakening during the night had increased in all groups. Children with CDC and ASD had significantly higher odds of taking more than 30min to fall asleep. The chance of having a WASO >30min increased in children with ASD but decreased in CDC ones. The quarantine period statistically increased the odds ratio of children having a sleep latency of >30min by nearly 5-fold for all groups. Conclusion: The CDC group presented worse sleep parameters overall, even before quarantine. In both the CDC and ASD group worse sleep indicators were found during the COVID-19 pandemic.

10.
Sleep Science ; 15:55, 2022.
Article in English | EMBASE | ID: covidwho-1935283

ABSTRACT

Introduction: Previous studies have reported that sleep deprivation and sleep disorders may decrease the antibody response after vaccination for H1N1, influenza and hepatitis A. Since the emergence of the current pandemic, the same was wondered for vaccination against COVID-19. This possible effect would be especially relevant among older adults, who are subjected to a high prevalence of sleep disorders (mainly obstructive sleep apnea - OSA) and who are at increased risk for severe COVID-19. Objective: To evaluate the effect of OSA on IgG antibody response after vaccination against COVID-19 among older adults. Methods: This study was based on a convenience sample of older adults who underwent polysomnography at the Sleep Institute (São Paulo, Brazil). It was considered eligible those who were 60 years or older, were undergoing full night type-I polysomnography, and have been fully vaccinated against COVID-19. The following exclusion criteria was applied: previous COVID-19 diagnosis, less than 15 days between last vaccine shot and IgG testing, or CPAP use in the last 3 months. All eligible participants undergone blood sampling for anti-SARS-CoV-2 IgG analysis. The apnea-hypopnea index (AHI) was used to categorize the participants in the following groups: no/mild OSA (IAH < 15), moderate OSA (AHI ≥ 15 and < 30) and severe OSA (AHI ≥ 30). The association between IgG reactive status (seronegative or seropositive) and OSA was evaluated by a X2 test. Log-transformed IgG levels were compared among OSA severity groups using a 1-way ANOVA with Welch's correction. Statistical analyses were performed using Jamovi 1.6 and the significance level was set as p<0.05. Results: The final sample comprised 122 participants, of which 35 had no/mild OSA, 31 had moderate and 56 had severe OSA. Seronegative anti-SARS-CoV-2 IgG results were observed in 9.8% of the sample, and the median IgG levels was 273 AU/ mL (IQR: 744) with no statistically significant differences among OSA severity groups in neither case. Conclusion: OSA does not appear to affect IgG antibody response following vaccination against older adults. This is a positive result from a public health perspective, since even being at increased risk for negative COVID-19 outcomes, vaccination among individuals with OSA seems to be equally effective as among those without OSA.

11.
Sleep ; 45(SUPPL 1):A310, 2022.
Article in English | EMBASE | ID: covidwho-1927437

ABSTRACT

Introduction: Sleep disorders and sleep deprivation induces decreased antibody response following vaccination for different viral diseases (including H1N1, influenza and hepatitis A). The same has been speculated for COVID-19. This study aimed to assess whether obstructive sleep apnea (OSA) reduces antibody levels after COVID-19 vaccination among older adults. Methods: This was a convenience-sample study composed of older adults (≥60 years old). Those who underwent polysomnography at the Sleep Institute (São Paulo, Brazil) and received complete COVID-19 vaccination schedule were considered eligible. Individuals with previous diagnosis of COVID-19, less than 15 days between vaccination and IgG testing, or CPAP use in the last 3 months were excluded. Anti-SARS-CoV-2 IgG levels were measured using a chemiluminescence assay. The participants were distributed in the following groups, according to their apneahypopnea index (AHI): no/mild OSA (AHI<15), moderate OSA (AHI≥15 and <30) and severe OSA (AHI≥30). The effects of OSA on IgG levels (ANOVA), the correlation between IgG levels and AHI (Spearman's correlation test) and the association between serostatus (positive vs. negative) and OSA severity levels (X2 test) were analysed. Results were considered as statistically significant when p<0.05. Results: The sample included 122 older adults (median age 72.0 - IQR: 5.7), of whom 35 (28.6%) had AHI no/mild OSA;31 (25.4%) had moderate OSA, and 56 (45.9%) had severe OSA. Oxford/ AstraZeneca was the most referred vaccine (n=111, 91.0%), followed by CoronaVac (n=9, 9.0%). Seropositive status (IgG count ≥50.0 AU/mL) was observed in 90.2% of the participants and the median IgG levels in the complete sample was 273.0 AU/ML (IQR: 744.0). No/mild, moderate and severe OSA groups presented IgG levels of 482.0 (IQR: 677.0), 285 (IQR: 884.0) and 181.0 (IQR: 598.0), respectively, with no statistical difference them (p=0.606). There was no statistically significant correlation between AHI index and IgG levels (Spearman's rho=-0.169, p=0.063) and no significant association between serostatus and OSA severity groups (X2=0.912;p=0.634). Conclusion: Anti-SARS-CoV-2 IgG levels after vaccination are not significantly affected by OSA among older adults. Thus, despite being at higher risk for severe cases, OSA does not decrease the antibody response following vaccination against COVID-19.

12.
Environmental Taxation in the Pandemic Era: Opportunities and Challenges ; : 1-265, 2021.
Article in English | Scopus | ID: covidwho-1876015

ABSTRACT

At a time when climate change and the Covid-19 pandemic pose a global existential threat, this timely and important book explores how policy responses to a pandemic create both opportunities and challenges for the increased use of environmental pricing instruments, such as carbon taxes, and tradable permit schemes, and targeted green fiscal incentives. © The Editors and Contributors severally 2021.

14.
Working Paper Series National Bureau of Economic Research ; 31(50), 2020.
Article in English | GIM | ID: covidwho-1789338

ABSTRACT

Due to COVID-19, 33 states banned elective medical procedures, and 13 of these states included surgical abortions. We collected street addresses of abortion clinics and linked them to SafeGraph's data on counts of visitors. We found a 32 percent decrease in clinics visits in February-May of 2020 compared to 2019. States that banned elective procedures saw an additional 23 percent decrease in visits. However, there was no significant additional decrease in the states that explicitly banned surgical abortions. We estimate that the decrease in foot traffic over these four months reduced abortions by 9 percent in 2020 relative to 2019.

15.
Journal of Crohn's and Colitis ; 16:i587-i588, 2022.
Article in English | EMBASE | ID: covidwho-1722362

ABSTRACT

Background: Population-based data regarding outcomes of coronavirus disease 2019 (COVID-19) among patients with ulcerative colitis (UC) and Crohn's disease (CD) remain limited. Methods: We conducted a population-based study investigating the outcomes of COVID-19 among patients with UC and CD in Denmark. The Danish COVID-19 IBD Database is an extensive populationbased database which prospectively monitors the disease course of laboratory-confirmed COVID-19 among patients with UC and CD. Severe COVID-19 was defined as COVID-19 necessitating intensive care unit admission, ventilator use, or death, while adverse COVID- 19 was defined as requirement of COVID-19 related hospitalization. Regression analysis was adjusted for age, sex, disease type, disease activity, cardiovascular disease, and corticosteroids. Outcomes of COVID-19 among patients with UC and CD were compared with those among the background population covering all incidents of COVID-19 in Denmark. Results: The study included 319 patients with UC and 197 patients with CD from January 28th, 2020, to April 1st, 2021. Baseline characteristics are presented in Table 1. A significantly higher risk of COVID- 19-related hospitalization was observed among patients with UC (N=46(14.4%), RR=2.49 (95%CI 1.91-3.26)) and CD (N=24(12.2%), RR=2.11 (95%CI 1.45-3.07)) as compared with the background population (N=13,306 (5.8%)). A similar pattern was observed for admission to intensive care (UC: N=8(2.51%), RR=27.88 (95%CI 13.88- 56.00);CD: N=3 (1.52%), RR=16.92 (95%CI 5.46-52.46)) (Figure 1). The association between these outcomes and IBD-related clinical characteristics and treatments is presented in Tables 2-3. As shown, none of the IBD-related medications were associated with severe COVID-19 in univariate and multivariable analysis. However, systemic steroids were found to be associated with an increased risk of adverse COVID-19 among patients with CD (adjusted odds ratio (aOR)=13.62 (95% CI 1.98-17.77)). Conclusion: This Danish population-based study on COVID-19 outcomes among patients with UC and CD demonstrated severe COVID-19 among only a minority of patients, which was not associated with IBD-related medications. Apart from systemic steroids, this study encourages continued use of IBD therapy to prevent IBD relapse and complications.

16.
Journal of Crohn's and Colitis ; 16:i562, 2022.
Article in English | EMBASE | ID: covidwho-1722355

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) pandemic raised concerns among patients with ulcerative colitis (UC) and Crohn's disease (CD) fearing an increased susceptibility to infection and increased risk of poor outcomes. Furthermore, the impact of COVID-19 on subsequent health-related quality of life (HRQoL) has so far not been described. We aimed to evaluate the HRQoL in relation to the severity of COVID-19 in a cohort of survivors. Methods: We conducted a population-based study investigating the outcomes of COVID-19 among patients with UC and CD in Denmark. The Danish COVID-19 IBD Database is an extensive populationbased database which prospectively monitors the disease course of laboratory-confirmed COVID-19 among patients with UC and CD. Severe COVID-19 was defined as COVID-19 necessitating intensive care unit admission, ventilator use, or death, while adverse COVID- 19 was defined as requirement of COVID-19 related hospitalization. HRQoL was assessed using several validated questionnaires, including the EuroQol five-dimension five-level (EQ-5D-5L) questionnaire, EuroQol Visual Analogue Scale (EQ-VAS), Short Inflammatory Bowel Disease Questionnaire (SIBDQ), IBD Disability Index (IBD-DI), and IBD Fatigue Score. Results: HRQoL after COVID-19 was assessed among 137/319 (42.9%) patients with UC of whom 125 (91.2%) and 12 (8.8%) patients experienced mild and adverse COVID-19, respectively. Furthermore, HRQoL was assessed among 85/197 (43.1%) patients with CD of whom 74 (87.1%) and 11 (12.9%) patients experienced mild and adverse COVID-19, respectively. HRQoL was assessed after a median of 5.1 months (IQR 4.5-7.9) after infection. Baseline characteristics are presented according to the availability of HRQoL data in Table 1. No difference was observed in terms of EQ-5D-5L among patients with UC and CD or patients with mild, adverse, or severe COVID-19 (Table 2). Accordingly, the SIBDQ scores were similar among patients with mild, adverse or severe COVID-19 and UC (mild: median 59 (IQR 50-65), adverse: 62 (54-65), severe: 62 (54-65), p=0.89) or CD (mild: 57 (46- 65), 58 (49-64), 58 (49-64), p=0.91) as well, and no difference was observed in the subscores (Table 2). In line with these results, the IBD Disability Index (UC: median 10 (IQR 6-16), CD: 13 (6-20), p=0.16) were not associated with the severity of COVID-19 (Table 3). Finally, CD patients with adverse COVID-19 experienced more fatigue than patients with mild COVID-19 (26 (IQR 25-35) vs. 41 (IQR 29-46), p=0.03). Conclusion: This Danish population-based study found no durable impact of COVID-19 on health-related quality of life among patients with inflammatory bowel disease providing further assurance for the clinical guidelines for IBD care during the pandemic.

17.
Journal of Crohn's and Colitis ; 16:i073-i074, 2022.
Article in English | EMBASE | ID: covidwho-1722301

ABSTRACT

Background: The vast majority of patients with ulcerative colitis (UC) and Crohn's disease (CD) who acquire coronavirus disease 2019 (COVID-19) survive the infection. Still, the long-term health consequences of COVID-19 are not well described in patients with underlying inflammatory bowel disease (IBD). Methods: We conducted a population-based study investigating the outcomes of COVID-19 among patients with UC and CD in Denmark. The Danish COVID-19 IBD Database is an extensive population-based database which prospectively monitors the disease course of laboratory-confirmed COVID-19 among patients with UC and CD. Severe COVID-19 was defined as COVID-19 necessitating intensive care unit admission, ventilator use, or death, while adverse COVID-19 was defined as requirement of COVID-19 related hospitalization. Sequelae following COVID-19 were defined as symptoms that developed during or after an infection consistent with COVID- 19, were present for more than 12 weeks, and were not attributable to alternative diagnoses. Results: The study included 319 patients with UC and 197 patients with CD from January 28th, 2020, to April 1st, 2021. Of these, a total of 137 (42.9%) and 85 (43.1%), respectively, participated in a subsequent investigation of post-COVID-19 sequelae after a median of 5.1 months (IQR 4.5-7.9) after infection (Table 1). An equal proportion of patients with UC (58 (42.3%)) and CD (39 (45.9%), p=0.60) reported persisting symptoms of COVID-19 for at least 12 weeks, consistent with the development of post-COVID-19 syndrome. The most common persisting patient-reported symptoms included fatigue (UC: 49 (35.8%), CD: 31 (36.5%), p=0.92), anosmia (UC: 37 (27.0%), CD: 25 (29.4%), p=0.70), ageusia (UC: 26 (19.0%), CD: 24 (28.2%), p=0.11), headache (UC: 19 (13.9%), CD: 16 (18.8%), p=0.32), dyspnea (UC: 19 (13.9%), CD: 16 (18.8%), p=0.32), and arthralgia (UC: 17 (12.4%), CD: 14 (16.5%), p=0.40) (Figure 1). Only discontinuation of immunosuppressive therapies for UC during COVID-19 (OR=1.50 (95% CI 1.07-10.22), p=0.01) and the severity of COVID-19 among patients with CD were independently associated with the long-term effects of COVID-19 (OR=2.76 (95% CI 1.05- 3.90), p=0.04) (Tables 2-3). Conclusion: This Danish population-based study found a high occurrence of patient-reported persisting symptoms following the acute phase of COVID-19 infection, which were associated with the discontinuation of immunosuppressive therapies for UC during COVID-19 and the severity of COVID-19 among patients with CD. These findings might have implications for planning the healthcare of patients with inflammatory bowel diseases in the post-COVID-19 era.

18.
Journal of Crohn's and Colitis ; 16:i071-i072, 2022.
Article in English | EMBASE | ID: covidwho-1722300

ABSTRACT

Background: Whether the disease activity of ulcerative colitis (UC) and Crohn's disease (CD) is correlated with the severity of coronavirus disease 2019 (COVID-19) remains poorly investigated with only few selected cohort studies having addressed this in the past. Methods: We conducted a population-based study investigating the outcomes of COVID-19 among patients with UC and CD in Denmark. The Danish COVID-19 IBD Database is an extensive population-based database which prospectively monitors the disease course of laboratory-confirmed COVID-19 among patients with UC and CD. Severe COVID-19 was defined as COVID-19 necessitating intensive care unit admission, ventilator use, or death, while adverse COVID-19 was defined as requirement of COVID-19 related hospitalization. Clinical disease activity was measured by simple clinical colitis index and Harvey-Bradshaw Index in UC and CD, respectively. The biochemical activity was defined as C-reactive protein higher than 5 mg/L or fecal calprotectin higher than 250 μg/g. The endoscopic activity was defined as Mayo Endoscopic Subscore of at least 2 in UC, or Simple Endoscopic Score Crohn's Disease of at least 3 for CD. Sequelae following COVID-19 were defined as symptoms that (i) developed during or after an infection consistent with COVID-19, (ii) and were present for more than 12 weeks, (iii) and were not attributable to alternative diagnoses. Results: During the inclusion period between January 28th, 2020, to April 1st, 2021, the study included 319 patients with UC and 197 patients with CD who developed laboratory confirmed COVID-19. Of these, data on clinical, biochemical, and endoscopic activity were available among 265/319 (83.1%), 319/319 (100.0%), and 66/319 (20.7%) of patients with UC, respectively, and 140/197 (71.1%), 131/197 (66.5%), and 42/197 (21.3%) of patients with CD. Figures 1-2 outlines the outcomes of COVID-19 according to the degree of clinical, biochemical and endoscopic disease activity. In both UC and CD, clinical, biochemical, and endoscopic activity were not associated with adverse or severe COVID-19, nor long-term outcomes, in unadjusted nor adjusted analysis (Table 1). Conclusion: In this population-based study, we found no association between disease activity of UC or CD and severity of COVID-19. These findings have implications for the risk stratification of patients with IBD acquiring COVID-19.

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