OUTCOMES OF HOSPITALIZED COVID-19 PATIENTS WITH INFLAMMATORY BOWEL DISEASE: A NATIONAL DATABASE STUDY

ABSTRACT

Background: Prior studies have shown no additional risk of severe outcomes in patients with inflammatory bowel disease (IBD) from COVID-19 infection unless they are experiencing disease flare or on steroids. Whether COVID-19 infected patients with IBD have worse outcomes than those without IBD is not clear. Aims: To examine risk factors for worse outcomes related to COVID-19 infection in IBD patients. Methods: The study cohort was derived from the Cerner Real World Data (CRWD) COVID-19 Database inclusive of hospitalized patients with COVID-19 infection from December 1, 2019 through November 30, 2020. Baseline demographics, comorbidities, and hospital characteristics were acquired. IBD patients were propensity-matched in 12 fashion to controls (those without IBD) to compare proportions of patients who experienced death, or worse outcomes such as acute respiratory distress syndrome (ARDS), mechanical ventilation and sepsis using odds ratio (OR) with 95% confidence intervals (CI). The impact of immune suppressing medications (steroids and biologics) among patients with ulcerative colitis (UC) and Crohn's disease (CD) was also examined. Results: Of 100,902 COVID-19 positive hospitalized patients, 316 (0.3%) were found to have a personal history of IBD UC=148 and CD=172 (mean age 49.5±20.9 years, 56% females;Table 1). Overall mortality was not significantly higher in COVID-19 hospitalized patients who had IBD compared to those without IBD (10.8% vs 8.5%;p= 0.79). On propensity-matching, there was no significant difference found between IBD patients on steroids (n=124) and non-IBD patients on steroids (n=161) for mortality (p= 0.45), mechanical ventilation (p=0.68), ARDS (p=0.30) or sepsis (p=0.50) -table 2. IBD patients on biologics (and other immunosuppressors) were not found to have any significant difference in these outcomes when compared to matched non-IBD patients on other immunosuppressors mortality (p=0.23), ARDS (p=0.056) or sepsis (p=0.19). Conclusion: In this large real-world data of hospitalized COVID-19 patients, IBD accounted for < 0.5% of total admissions and those with IBD did not have worse outcomes or increased mortality compared to those without IBD, including those takings immune suppressive medications (Table Presented) (Table Presented)