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炎症性肠病患者与对照人群 COVID-19 发病风险比较。

Risk of COVID 19 in patients with inflammatory bowel diseases compared to a control population.

机构信息

Gastroenterology Unit, ASST Fatebenefratelli Sacco, Department of Biomedical and Clinical Sciences "L.Sacco" University of Milan, Italy.

Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

出版信息

Dig Liver Dis. 2021 Mar;53(3):263-270. doi: 10.1016/j.dld.2020.12.013. Epub 2020 Dec 26.

Abstract

BACKGROUND

It is unclear whether patients with inflammatory bowel disease (IBD) are at increased risk of COVID-19.

OBJECTIVES

This observational study compared the prevalence of COVID-19 symptoms, diagnosis and hospitalization in IBD patients with a control population with non-inflammatory bowel disorders.

METHODS

This multicentre study, included 2733 outpatients (1397 IBD patients and 1336 controls), from eight major gastrointestinal centres in Lombardy, Italy. Patients were invited to complete a web-based questionnaire regarding demographic, historical and clinical features over the previous 6 weeks. The prevalence of COVID-19 symptoms, diagnosis and hospitalization for COVID-19 was assessed.

RESULTS

1810 patients (64%) responded to the questionnaire (941 IBD patients and 869 controls). IBD patients were significantly younger and of male sex than controls. NSAID use and smoking were more frequent in controls. IBD patients were more likely treated with vitamin-D and vaccinated for influenza. Highly probable COVID-19 on the basis of symptoms and signs was less frequent in the IBD group (3.8% vs 6.3%; OR:0.45, 95%CI:0.28-0.75). IBD patients had a lower rate of nasopharyngeal swab-PCR confirmed diagnosis (0.2% vs 1.2%; OR:0.14, 95%CI:0.03-0.67). There was no difference in hospitalization between the groups (0.1% vs 0.6%; OR:0.14, 95%CI:0.02-1.17).

CONCLUSION

IBD patients do not have an increased risk of COVID-19 specific symptoms or more severe disease compared with a control group of gastroenterology patients.

摘要

背景

目前尚不清楚炎症性肠病(IBD)患者是否有更高的 COVID-19 风险。

目的

本观察性研究比较了 IBD 患者与非炎症性肠病患者的 COVID-19 症状、诊断和住院率。

方法

这项多中心研究纳入了来自意大利伦巴第地区 8 个主要胃肠中心的 2733 名门诊患者(1397 名 IBD 患者和 1336 名对照)。患者被邀请填写一份关于过去 6 周内人口统计学、历史和临床特征的网络问卷。评估 COVID-19 症状、COVID-19 诊断和 COVID-19 住院的发生率。

结果

1810 名患者(64%)回答了问卷(941 名 IBD 患者和 869 名对照)。IBD 患者比对照组更年轻,且为男性。对照组中 NSAID 使用率和吸烟率更高。IBD 患者更可能接受维生素 D 治疗和流感疫苗接种。根据症状和体征高度怀疑 COVID-19 的患者在 IBD 组中更为少见(3.8%比 6.3%;OR:0.45,95%CI:0.28-0.75)。IBD 患者鼻咽拭子 PCR 确诊诊断率较低(0.2%比 1.2%;OR:0.14,95%CI:0.03-0.67)。两组间住院率无差异(0.1%比 0.6%;OR:0.14,95%CI:0.02-1.17)。

结论

与胃肠病学对照组相比,IBD 患者 COVID-19 特异性症状或更严重疾病的风险没有增加。

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