炎症性肠病患者 COVID-19 的临床结局：一项全国性队列研究。
Clinical Outcomes of Covid-19 in Patients With Inflammatory Bowel Disease: A Nationwide Cohort Study.
机构信息
Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Zuyderland Medical Centre, Department of Gastroenterology, Geriatrics, Internal and Intensive Care Medicine (Co-MIK), Sittard-Geleen, The Netherlands.
出版信息
J Crohns Colitis. 2021 Apr 6;15(4):529-539. doi: 10.1093/ecco-jcc/jjaa215.
BACKGROUND AND AIMS
The COVID-19 risk and disease course in inflammatory bowel disease [IBD] patients remains uncertain. Therefore, we aimed to assess the clinical presentation, disease course, and outcomes of COVID-19 in IBD patients. Second, we determined COVID-19 incidences in IBD patients and compared this with the general population.
METHODS
We conducted a multicentre, nationwide IBD cohort study in The Netherlands and identified patients with COVID-19. First, we assessed the COVID-19 disease course and outcomes. Second, we compared COVID-19 incidences between our IBD study cohort and the general Dutch population.
RESULTS
We established an IBD cohort of 34 763 patients. COVID-19 was diagnosed in 100/34 763 patients [0.29%]; 20/100 of these patients [20%] had severe COVID-19 defined as admission to the intensive care unit, mechanical ventilation, and/or death. Hospitalisation occurred in 59/100 [59.0%] patients and 13/100 [13.0%] died. All patients who died had comorbidities and all but one were ≥65 years old. In line, we identified ≥1 comorbidity as an independent risk factor for hospitalisation (odds ratio [OR] 4.20, 95% confidence interval [CI] 1.58-11.17,; p = 0.004). Incidences of COVID-19 between the IBD study cohort and the general population were comparable (287.6 [95% CI 236.6-349.7] versus 333.0 [95% CI 329.3-336.7] per 100000 patients, respectively; p = 0.15).
CONCLUSIONS
Of 100 cases with IBD and COVID-19, 20% developed severe COVID-19, 59% were hospitalised and 13% died. A comparable COVID-19 risk was found between the IBD cohort [100/34 763 = 0.29%] and the general Dutch population. The presence of ≥1 comorbidities was an independent risk factor for hospitalisation due to COVID-19.
背景与目的
COVID-19 在炎症性肠病（IBD）患者中的风险和疾病进程仍不确定。因此，我们旨在评估 IBD 患者 COVID-19 的临床表现、疾病进程和结局。其次，我们确定了 IBD 患者 COVID-19 的发生率，并将其与普通人群进行了比较。
方法
我们在荷兰进行了一项多中心、全国性的 IBD 队列研究，并确定了 COVID-19 患者。首先，我们评估了 COVID-19 的疾病进程和结局。其次，我们将我们的 IBD 研究队列与普通荷兰人群的 COVID-19 发生率进行了比较。
结果
我们建立了一个 34763 例患者的 IBD 队列。100/34763 例（0.29%）患者诊断为 COVID-19；20/100 例（20%）患者患有严重 COVID-19，定义为入住重症监护病房、机械通气和/或死亡。59/100 例（59.0%）患者住院，13/100 例（13.0%）死亡。所有死亡患者均有合并症，且均≥65 岁。同样，我们发现≥1 种合并症是住院的独立危险因素（比值比 [OR] 4.20，95%置信区间 [CI] 1.58-11.17；p = 0.004）。IBD 研究队列和普通人群的 COVID-19 发生率相当（IBD 研究队列为 287.6 [95%CI 236.6-349.7]，普通人群为 333.0 [95%CI 329.3-336.7]每 100000 例患者；p = 0.15）。
结论
在 100 例患有 IBD 和 COVID-19 的患者中，20%患有严重 COVID-19，59%住院，13%死亡。在 IBD 队列 [100/34763 = 0.29%] 和普通荷兰人群中发现 COVID-19 风险相当。≥1 种合并症是 COVID-19 住院的独立危险因素。
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