Gastrounit, Medical Division, Hvidovre University Hospital, Hvidovre, Denmark.
Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark.
J Crohns Colitis. 2021 Apr 6;15(4):540-550. doi: 10.1093/ecco-jcc/jjaa205.
As no population-based study has investigated the susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases [IBD], we aimed to investigate this topic in a population-based setting.
Two cohorts were investigated. First, a nationwide cohort of all IBD patients diagnosed with COVID-19 was prospectively followed to investigate the disease courses of both diseases. Second, within a population-based cohort of 2.6 million Danish citizens, we identified all individuals tested for SARS-CoV-2 to determine the occurrence of COVID-19 among patients with and without IBD and other immune-mediated inflammatory diseases [IMIDs].
Between January 28, 2020 and June 2, 2020, a total of 76 IBD patients with COVID-19 were identified in the national cohort and prospectively followed for 35 days (interquartile range [IQR]: 25-51). A large proportion [n = 19: 25%] required a COVID-19-related hospitalisation for 7 days [IQR: 2-8.5] which was associated with being 65 years or older (odds ratio [OR] = 23].80, 95% confidence interval [CI] 6.32-89.63, p <0.01) and presence of any non-IMID comorbidity [OR = 8.12, 95% CI 2.55-25.87, p <0.01], but not use of immunomodulators [p = 0.52] or biologic therapies [p = 0.14]. In the population-based study, 8476 of 231 601 [3.7%] residents tested positive for SARS-CoV-2; however, the occurrence was significantly lower among patients with IBD [62 of the 2486 patients = 2.5%, p <0.01] and other IMIDs [531 of 16 492 patients = 3.2%, p <0.01] as compared with patients without IMIDs.
Patients with IMIDs, including IBD, had a significantly lower susceptibility to COVID-19 than patients without IMIDs, and neither immunosuppressive therapies nor IBD activity were associated with the disease course of COVID-19.
由于没有基于人群的研究调查过炎症性肠病（IBD）患者感染 COVID-19 的易感性和疾病过程，因此我们旨在基于人群的研究中调查这一课题。
我们调查了两个队列。首先，前瞻性地随访了一个全国性的 IBD 患者确诊 COVID-19 的队列，以调查这两种疾病的疾病过程。其次，在一个基于 260 万丹麦公民的人群队列中，我们确定了所有接受 SARS-CoV-2 检测的个体，以确定 IBD 患者和无 IBD 及其他免疫介导的炎症性疾病（IMIDs）患者中 COVID-19 的发生情况。
在 2020 年 1 月 28 日至 2020 年 6 月 2 日期间，全国性队列共发现 76 例 IBD 合并 COVID-19 的患者，并前瞻性随访了 35 天（四分位距 [IQR]：25-51）。相当大的比例（n=19：25%）需要因 COVID-19 住院 7 天[IQR：2-8.5]，与 65 岁或以上相关（比值比 [OR] =23.80，95%置信区间 [CI] 6.32-89.63，p<0.01）和存在任何非 IMID 合并症（OR=8.12，95%CI 2.55-25.87，p<0.01），但与免疫调节剂的使用无关（p=0.52）或生物疗法（p=0.14）。在基于人群的研究中，231601 名居民中有 8476 名（3.7%）对 SARS-CoV-2 检测呈阳性；然而，与无 IMIDs 的患者相比，IBD（2486 名患者中的 62 名，2.5%，p<0.01）和其他 IMIDs（16492 名患者中的 531 名，3.2%，p<0.01）患者的阳性率显著更低。
包括 IBD 在内的 IMIDs 患者感染 COVID-19 的易感性明显低于无 IMIDs 的患者，且免疫抑制治疗和 IBD 活动与 COVID-19 的疾病过程无关。
