Inflammatory Bowel Disease Unit, Department of Gastroenterology, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain.
Department of Internal Medicine, Hospital Clínico San Carlos and Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], Madrid, Spain.
Aliment Pharmacol Ther. 2020 Jul;52(2):276-283. doi: 10.1111/apt.15804. Epub 2020 Jun 7.
Data on patients with inflammatory bowel diseases (IBD) who have had 2019 novel coronavirus (SARS-CoV-2) disease (COVID-19) are needed.
To report the clinical characteristics, including gastrointestinal symptoms, of COVID-19 in IBD patients, and to assess the risk of COVID-19 in IBD.
This case series included consecutive IBD patients with laboratory-confirmed COVID-19. Age-adjusted cumulative incidences were compared with the general population in the Madrid region.
Through April 8, 12 of 1918 IBD patients were diagnosed with COVID-19. The average age was 52 years, 75% of the patients were female and 58.3% had Crohn's disease. Seven patients (58%) were on maintenance treatment with immunomodulators/biologics, of these four with combined therapy (33%). Eight patients (66%) required hospitalisation (one intensive care unit admission, and two deaths), and four patients were isolated at home. Nine patients had diarrhoea ranging between 4 and 10 loose stools per day (mean 5.4, SD 1.6). In five patients (42%) diarrhoea was a presenting symptom. In two patients, diarrhoea was the only symptom at debut. Cumulative incidence of COVID-19 was 6.2 per 1000 IBD patients. IBD patients had a lower adjusted incidence ratio of COVID-19 (OR 0.74, 95% CI 0.70-0.77; P < 0.001), and a similar associated mortality ratio (OR 0.95, 95% CI: 0.84-1.06; P = 0.36), compared with the general population.
IBD patients do not have an increased risk of COVID-19 and associated mortality compared with the general population. In many IBD patients, diarrhoea was a presenting symptom, and sometimes, was the only symptom at onset of COVID-19.
需要了解患有 2019 年新型冠状病毒（SARS-CoV-2）疾病（COVID-19）的炎症性肠病（IBD）患者的临床特征，包括胃肠道症状。
报告 COVID-19 在 IBD 患者中的临床特征，包括胃肠道症状，并评估 IBD 患者 COVID-19 的风险。
本病例系列包括经实验室确诊的 COVID-19 的连续 IBD 患者。将年龄调整后的累积发病率与马德里地区的一般人群进行比较。
截至 4 月 8 日，1918 例 IBD 患者中确诊 12 例 COVID-19。平均年龄为 52 岁，75%的患者为女性，58.3%患有克罗恩病。7 例（58%）患者正在接受免疫调节剂/生物制剂的维持治疗，其中 4 例联合治疗（33%）。8 例（66%）患者需要住院治疗（1 例入住重症监护病房，2 例死亡），4 例患者在家中隔离。9 例患者腹泻，每天 4-10 次稀便（平均 5.4 次，标准差 1.6）。在 5 例患者（42%）中，腹泻是首发症状。在 2 例患者中，腹泻是首发症状。COVID-19 的累积发病率为每 1000 例 IBD 患者 6.2 例。与一般人群相比，IBD 患者 COVID-19 的调整发病率比值较低（OR 0.74，95%CI 0.70-0.77；P<0.001），且相关死亡率比值相似（OR 0.95，95%CI：0.84-1.06；P=0.36）。
与一般人群相比，IBD 患者 COVID-19 的发病风险和相关死亡率没有增加。在许多 IBD 患者中，腹泻是首发症状，有时也是 COVID-19 发病的唯一症状。
