Crohn's and Colitis Center, Massachusetts General Hospital, Boston, MA.
Harvard Medical School, Boston, MA.
Inflamm Bowel Dis. 2021 Jan 19;27(2):155-161. doi: 10.1093/ibd/izaa278.
The effect of immunosuppressive treatment for immune-mediated diseases on risk of the novel coronavirus disease 2019 (COVID-19) has not been established. We aimed to define the effect of targeted biologic and immunomodulator therapy on risk of COVID-19 in a multi-institutional cohort of patients with inflammatory bowel disease (IBD).
We identified patients 18 years and older who received care for IBD at Partners Healthcare between January 2019 and April 2020. The primary outcome was development of COVID-19 defined as a positive polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2. Multivariable regression models were used to examine the effect of immunosuppression on risk of COVID-19 and its outcomes.
In a cohort of 5302 IBD patients, 39 (0.7%) developed COVID-19. There was no difference in age, sex, or race between IBD patients with and without COVID-19. The rate of COVID-19 was similar between patients treated with immunosuppression (0.8%) compared with those who were not (0.64%; P = 0.55). After adjusting for age, sex, race, and comorbidities, use of immunosuppressive therapy was not associated with an increased risk of COVID-19 (odds ratio, 1.73; 95% confidence interval, 0.82-3.63). The presence of obesity was associated with a higher risk of COVID-19 (odds ratio, 8.29; 95% confidence interval, 3.72-18.47). There were 7 hospitalizations, 3 intensive care unit stays, and 1 death. Older age and obesity but not immunosuppressive treatment were associated with severe COVID-19 infection.
The use of systemic immunosuppression was not associated with an increased risk of COVID-19 in a multi-institutional cohort of patients with IBD.
免疫抑制治疗对免疫介导性疾病的影响尚未确定新型冠状病毒病 2019（COVID-19）的风险。我们旨在定义靶向生物制剂和免疫调节剂治疗对炎症性肠病（IBD）多机构队列患者 COVID-19 风险的影响。
我们确定了 2019 年 1 月至 2020 年 4 月期间在合作伙伴医疗保健中心接受 IBD 治疗的年龄在 18 岁及以上的患者。主要结局是发展 COVID-19，定义为严重急性呼吸综合征冠状病毒 2 的聚合酶链反应检测呈阳性。多变量回归模型用于检查免疫抑制对 COVID-19 风险及其结果的影响。
在 5302 例 IBD 患者的队列中，39 例（0.7%）发生 COVID-19。IBD 患者中 COVID-19 患者与无 COVID-19 患者在年龄、性别或种族方面无差异。与未接受免疫抑制治疗的患者相比，接受免疫抑制治疗的患者 COVID-19 的发生率相似（0.8%对 0.64%；P=0.55）。调整年龄、性别、种族和合并症后，使用免疫抑制疗法与 COVID-19 风险增加无关（优势比，1.73；95%置信区间，0.82-3.63）。肥胖的存在与 COVID-19 的风险增加相关（优势比，8.29；95%置信区间，3.72-18.47）。有 7 例住院，3 例重症监护病房住院，1 例死亡。年龄较大和肥胖但不是免疫抑制治疗与严重 COVID-19 感染相关。
在 IBD 多机构队列中，全身性免疫抑制治疗与 COVID-19 风险增加无关。
