Department of Pediatric Gastroenterology, University of North Carolina, Chapel Hill, North Carolina.
Hôpital Necker Enfants Malades, APHP, Université de Paris, Paris, France.
Clin Gastroenterol Hepatol. 2021 Feb;19(2):394-396.e5. doi: 10.1016/j.cgh.2020.10.010. Epub 2020 Oct 12.
The coronavirus disease 2019 (COVID-19) pandemic caused by the highly infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents most often with mild clinical symptoms, but the severe forms are of major concern. SARS-CoV-2 enters human cells via the angiotensin-converting enzyme 2 receptor, expressed on epithelial and endothelial cells. Because the highest angiotensin-converting enzyme 2 expression is in the terminal ileum and colon, and up-regulated further during inflammation, and many COVID-19 patients experience gastrointestinal symptoms, longitudinal data are necessary to determine whether inflammatory bowel disease (IBD) patients are at risk for severe or complicated COVID-19. A recent analysis in IBD patients from the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) registry showed older age, steroid medication, and comorbidities as risk factors for severe evolution, and the same study showed that the 29 IBD patients younger than age 20 had only mild disease courses. This report describes the disease course of COVID-19 in an expanded sample of pediatric IBD patients from 2 international databases.
由高传染性的严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）大流行，多数情况下表现为轻微的临床症状，但严重形式引起了极大关注。SARS-CoV-2 通过在肠上皮细胞和血管内皮细胞表达的血管紧张素转换酶 2 受体进入人体细胞。由于肠末端和结肠表达的血管紧张素转换酶 2 最高，且在炎症期间进一步上调，且许多 COVID-19 患者出现胃肠道症状，因此需要纵向数据来确定炎症性肠病（IBD）患者是否存在 COVID-19 严重或并发症的风险。最近对来自监测炎症性肠病排除冠状病毒研究（SECURE-IBD）登记处的 IBD 患者的分析表明，年龄较大、类固醇药物和合并症是严重进展的危险因素，同一研究表明，20 岁以下的 29 名 IBD 患者仅表现为轻度病程。本报告描述了来自 2 个国际数据库的扩展的儿科 IBD 患者样本中 COVID-19 的疾病过程。
