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Mild COVID-19 disease among children with inflammatory bowel disease: An update from the secure-IBD registry
Journal of Pediatric Gastroenterology and Nutrition ; 73(1 SUPPL 1):S73-S74, 2021.
Article in English | EMBASE | ID: covidwho-1529222
ABSTRACT

Background:

Children who develop coronavirus disease 2019 (COVID-19) tend to have a mild disease course, although a small percentage develop more severe disease and/or multi-organ inflammatory syndrome. Children with inflammatory bowel diseases (IBD) are often treated with immune suppressive medications that may increase their risk of complications from infection. We describe the disease course of COVID-19 in children with IBD based on updated data from the SECURE-IBD database.

Methods:

The Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) was created in March 2020 to monitor outcomes of COVID-19 occurring in IBD patients and includes cases from the parallel Paediatric IBD Porto group of the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN). We included all subjects ≤18 years of age from the SECURE-IBD database through May 18th, 2021. We used descriptive statistics to summarize the demographic and disease characteristics of the study population, both overall and stratified by hospitalization status (hospitalized versus outpatient only), and performed bivariate comparisons. We performed a post-hoc logistic regression analysis evaluating the association of sulfasalazine/mesalamine use and hospitalization while adjusting for disease activity.

Results:

We collected 540 COVID-19 cases in pediatric IBD patients from 35 countries. The most common IBD treatment was TNF antagonist monotherapy (48%), followed by sulfasalazine/mesalamine (21%). Most patients (86%) had no comorbidities other than IBD. There were no deaths in the study population, and 14 children (4%) were hospitalized, of whom only two (0.4%) required mechanical ventilation. Both children requiring mechanical ventilation were on mesalamine, had ulcerative colitis, and were 6 and 7 years old, respectively. Factors associated with hospitalization included comorbid conditions other than IBD (35% hospitalized vs 13% not;p value <0.01), moderate/severe IBD disease activity (57% vs 14%;p value <0.01 overall), gastrointestinal symptoms (65% vs 16%, p value <0.01), Hispanic ethnicity (30% vs 14%;p value 0.03), sulfasalazine/mesalamine use (39% vs 21%;p value 0.03), and steroid use (26% vs 6%, p value <0.01). TNF antagonist monotherapy was associated with a decreased likelihood of hospitalization (22% vs 49%;p value 0.01) (Table). Sulfasalazine/mesalamine use was not a significant a risk factor after adjusting for disease activity (aOR 2.19, 95% confidence interval 0.86-5.55).

Discussion:

In this updated and expanded analysis of an international COVID-19 reporting registry, we observed that children with IBD have a relatively low risk of severe COVID-19, even while receiving immune suppressive IBD treatments. These findings may reassure families of children with IBD and inform decisions regarding return to school and activity.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of Pediatric Gastroenterology and Nutrition Year: 2021 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of Pediatric Gastroenterology and Nutrition Year: 2021 Document Type: Article