Clinical Outcomes of COVID-19 and Impact on Disease Course in Patients with Inflammatory Bowel Disease.
Can J Gastroenterol Hepatol
; 2021: 7591141, 2021.
Article
in English
| MEDLINE | ID: covidwho-1551096
ABSTRACT
Background and Aims:
The impact of COVID-19 has been of great concern in patients with inflammatory bowel disease (IBD) worldwide, including an increased risk of severe outcomes and/or possible flare of IBD. This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-19 or flare of IBD activity.Methods:
A consecutive cohort of IBD patients who were diagnosed with COVID-19 infection and followed up at the McGill University Health Care Centre was obtained between March 1, 2020, and April 30, 2021. Demographics, comorbidities, IBD (type, treatments, pre- and post-COVID-19 clinical activity, biomarkers, and endoscopic activity), and COVID-19-related outcomes (pneumonia, hospitalization, death, and flare of IBD disease) were analyzed.Results:
A cohort of 3,516 IBD patients was included. 82 patients (2.3%) were diagnosed with COVID-19 infection (median age 39.0 (IQR 27.8-48.0), 77% with Crohn's disease, 50% were female). The prevalence of COVID-19 infection in IBD patients was significantly lower compared to the general population in Canada and Quebec (3.5% versus 4.3%, p < 0.001). Severe COVID-19 occurred in 6 patients (7.3%); 2 patients (2.4%) died. A flare of IBD post-COVID-19 infection was reported in 8 patients (9.8%) within 3 months. Biologic therapy was held during active COVID-19 infection in 37% of patients. Age ≥55 years (odds ratio (OR) 11.1, 95% CI 1.8-68.0), systemic corticosteroid use (OR 4.6, 95% CI 0.7-30.1), active IBD (OR 3.8, 95% CI 0.7-20.8), and comorbidity (OR 4.9, 95% CI 0.8-28.6) were factors associated with severe COVID-19. After initial infection, 61% of IBD patients received COVID-19 vaccinations.Conclusion:
The prevalence of COVID-19 infection among patients with IBD was lower than that in the general population in Canada. Severe COVID-19, mortality, and flare of IBD were relatively rare, while a large proportion of patients received COVID-19 vaccination. Older age, comorbidities, active IBD disease, and systemic corticosteroid, but not immunosuppressive or biological therapy, were associated with severe COVID-19 infection.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Inflammatory Bowel Diseases
/
Crohn Disease
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Middle aged
Language:
English
Journal:
Can J Gastroenterol Hepatol
Year:
2021
Document Type:
Article
Affiliation country:
2021
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