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ABSTRACT

Introduction:

The exhaustive registry of COVID-19 cases in patients with IBD is a unique opportunity to learn how to deal with this infection, especially in reference to the management of immunosuppressive treatment, isolation measures or if the disease is more severe in IBD patients due to immunosuppression. Aims &

Methods:

Aims:

The aims of this study were to know the incidence and characteristics of COVID-19 in the ENEIDA cohort during the first wave of the pandemic;the outcomes among those under immunosuppressants/ biologics for IBD;the risk factors for contracting the infection and poor outcomes;and the impact of the infection after three-month followup.

Methods:

Prospective observational cohort study of all IBD patients with COVID-19 included in the ENEIDA registry (with 60.512 patients in that period) between March and July 2020, with at least 3 months of follow-up. Any patient with a confirmed (by PCR or SARS-CoV-2 serology) or probable (suggestive clinical picture) infection was considered as a case.

Results:

A total of 482 patients with COVID-19 from 63 centres were included 247 Crohn's disease, 221 ulcerative colitis and 14 unclassified colitis;median age 52 years (IQR 42-61), 48% women and 44% 1 comorbidity. Diagnosis was made by PCR 62% and serology 35%. The most frequent symptoms fever (69%), followed by cough (63%) and asthenia (38%). During lockdown 78% followed strict isolation. 35% required hospital admission (ICU 2.7%) and 12% fulfilled criteria for SIRS upon admission. 18 patients died from COVID-19 (mortality3.7%). 12% stop IBD medication during COVID-19. At 3 months, taken into account all included cases, 76% were in remission of IBD. Age 50 years (OR 2.09;95% CI1.27-3.4;p=0.004), 1 comorbidities (OR 2.28;95% CI1.4-3.6;p=0.001), and systemic steroids <3 months before infection (OR 1.3;95%CI1-1.6;p= 0.003), were risk factors for hospitalisation due to COVID-19. A Charlson score 2 (OR 5.4;95%CI1.5-20.1;p=0.01) was associated with ICU admission. Age 60 years (OR 7.1;95%CI1.8-27.4;p=0.004) and having 2 comorbidities (OR 3.9;95% CI1.3-11.6;p=0.01) were risk factors for COVID- 19 related death.

Conclusion:

IBD does not seem to worsen the prognosis of COVID-19, even when immunosuppressants and biological drugs are used. Age and comorbidity are the most important prognostic factors for more severe COVID-19 in IBD patients.

Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: United European Gastroenterology Journal Year: 2021 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Type of study: Prognostic study Language: English Journal: United European Gastroenterology Journal Year: 2021 Document Type: Article