Division of Gastroenterology, McGill University Health Center, Montreal, Canada.
Gastroenterology and Hepatology Unit, Division of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
Can J Gastroenterol Hepatol. 2021 Nov 30;2021:7591141. doi: 10.1155/2021/7591141. eCollection 2021.
The impact of COVID-19 has been of great concern in patients with inflammatory bowel disease (IBD) worldwide, including an increased risk of severe outcomes and/or possible flare of IBD. This study aims to evaluate prevalence, outcomes, the impact of COVID-19 in patients with IBD, and risk factors associated with severe COVID-19 or flare of IBD activity.
A consecutive cohort of IBD patients who were diagnosed with COVID-19 infection and followed up at the McGill University Health Care Centre was obtained between March 1, 2020, and April 30, 2021. Demographics, comorbidities, IBD (type, treatments, pre- and post-COVID-19 clinical activity, biomarkers, and endoscopic activity), and COVID-19-related outcomes (pneumonia, hospitalization, death, and flare of IBD disease) were analyzed.
A cohort of 3,516 IBD patients was included. 82 patients (2.3%) were diagnosed with COVID-19 infection (median age: 39.0 (IQR 27.8-48.0), 77% with Crohn's disease, 50% were female). The prevalence of COVID-19 infection in IBD patients was significantly lower compared to the general population in Canada and Quebec (3.5% versus 4.3%, < 0.001). Severe COVID-19 occurred in 6 patients (7.3%); 2 patients (2.4%) died. A flare of IBD post-COVID-19 infection was reported in 8 patients (9.8%) within 3 months. Biologic therapy was held during active COVID-19 infection in 37% of patients. Age ≥55 years (odds ratio (OR): 11.1, 95% CI: 1.8-68.0), systemic corticosteroid use (OR: 4.6, 95% CI: 0.7-30.1), active IBD (OR: 3.8, 95% CI: 0.7-20.8), and comorbidity (OR: 4.9, 95% CI: 0.8-28.6) were factors associated with severe COVID-19. After initial infection, 61% of IBD patients received COVID-19 vaccinations.
The prevalence of COVID-19 infection among patients with IBD was lower than that in the general population in Canada. Severe COVID-19, mortality, and flare of IBD were relatively rare, while a large proportion of patients received COVID-19 vaccination. Older age, comorbidities, active IBD disease, and systemic corticosteroid, but not immunosuppressive or biological therapy, were associated with severe COVID-19 infection.
COVID-19 对全球炎症性肠病（IBD）患者的影响引起了极大关注，包括严重后果风险增加和/或 IBD 发作的可能性。本研究旨在评估 IBD 患者 COVID-19 的流行率、结局、对 IBD 的影响以及与 COVID-19 严重程度或 IBD 活动发作相关的危险因素。
我们获取了 2020 年 3 月 1 日至 2021 年 4 月 30 日期间在麦吉尔大学医疗中心确诊 COVID-19 感染并接受随访的连续 IBD 患者队列。分析了人口统计学、合并症、IBD（类型、治疗、COVID-19 前后的临床活动、生物标志物和内镜活动）和 COVID-19 相关结局（肺炎、住院、死亡和 IBD 疾病发作）。
纳入了 3516 例 IBD 患者。82 例（2.3%）患者被诊断为 COVID-19 感染（中位年龄：39.0（IQR 27.8-48.0），77%为克罗恩病，50%为女性）。与加拿大和魁北克的一般人群相比，IBD 患者 COVID-19 感染的患病率明显较低（3.5%比 4.3%，<0.001）。6 例（7.3%）患者发生严重 COVID-19；2 例（2.4%）患者死亡。8 例（9.8%）患者在 COVID-19 感染后 3 个月内报告 IBD 发作。37%的患者在 COVID-19 感染期间暂停了生物治疗。≥55 岁（比值比（OR）：11.1，95%置信区间（CI）：1.8-68.0）、全身皮质类固醇使用（OR：4.6，95%CI：0.7-30.1）、活动性 IBD（OR：3.8，95%CI：0.7-20.8）和合并症（OR：4.9，95%CI：0.8-28.6）是 COVID-19 严重程度的相关因素。初始感染后，61%的 IBD 患者接种了 COVID-19 疫苗。
IBD 患者 COVID-19 感染的流行率低于加拿大一般人群。严重 COVID-19、死亡率和 IBD 发作相对罕见，而大多数患者接种了 COVID-19 疫苗。年龄较大、合并症、活动性 IBD 疾病以及全身皮质类固醇，而不是免疫抑制或生物治疗，与 COVID-19 严重感染相关。
