Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Arch Iran Med. 2022 Jan 1;25(1):17-25. doi: 10.34172/aim.2022.04.
Most data on the effect of inflammatory bowel disease (IBD) and its treatments on coronavirus disease 2019 (COVID-19) outcomes have not had non-IBD comparators. Hence, we aimed to describe COVID-19 outcomes in IBD compared to non-IBD patients.
We conducted a prospective cohort study of registered IBD patients with confirmed COVID-19 from six provinces in Iran from February to April 2020. Proven COVID-19 patients were followed up at four weeks and the frequency of outcomes was assessed. Multivariable logistic regression was used to assess associations between demographics, clinical characteristics and COVID-19 outcomes.
Overall, 2159 IBD patients and 4721 household members were enrolled, with 84 (3.9%) and 49 (1.1%) participants having confirmed COVID-19, respectively. Household spread of COVID-19 was not common in this cohort (1.2%). While hospitalization was significantly more frequent in IBD patients compared with non-IBD household members (27.1% vs. 6.0%, =0.002), there was no significant difference in the frequency of severe cases. Age and presence of IBD were positively associated with hospitalization in IBD compared with non-IBD household members (OR: 1.06, 95% CI: 1.03-1.10; OR: 5.7, 95% CI: 2.02- 16.07, respectively). Age, presence of new gastrointestinal symptoms, and 5-aminosalicylic acid (5-ASA) use were associated with higher hospitalization rate in IBD patients (OR: 1.13, 95% CI: 1.05-1.23; OR: 6.49, 95% CI: 1.87-22.54; OR: 6.22, 95% CI: 1.90-20.36, respectively). Anti-tumor necrosis factor (TNF) was not associated with more severe outcomes.
Age, presence of new gastrointestinal symptoms and use of 5-ASA were associated with increased hospitalization rate among IBD patients, while anti-TNF therapy had no statistical association.
大多数关于炎症性肠病（IBD）及其治疗对 2019 年冠状病毒病（COVID-19）结局影响的数据都没有非 IBD 对照组。因此，我们旨在描述 IBD 患者与非 IBD 患者的 COVID-19 结局。
我们对 2020 年 2 月至 4 月期间来自伊朗六个省份的确诊 COVID-19 的注册 IBD 患者进行了前瞻性队列研究。对确诊 COVID-19 的患者在四周时进行随访，并评估结局的发生频率。采用多变量逻辑回归评估人口统计学、临床特征与 COVID-19 结局之间的关联。
总体而言，共纳入 2159 名 IBD 患者和 4721 名家庭成员，其中 84（3.9%）和 49（1.1%）名参与者确诊 COVID-19。该队列中家庭传播 COVID-19 并不常见（1.2%）。虽然 IBD 患者的住院率明显高于非 IBD 家庭成员（27.1% vs. 6.0%，=0.002），但严重病例的频率无显著差异。与非 IBD 家庭成员相比，年龄和 IBD 的存在与 IBD 患者的住院治疗呈正相关（OR：1.06，95%CI：1.03-1.10；OR：5.7，95%CI：2.02-16.07）。年龄、新发胃肠道症状和 5-氨基水杨酸（5-ASA）的使用与 IBD 患者的更高住院率相关（OR：1.13，95%CI：1.05-1.23；OR：6.49，95%CI：1.87-22.54；OR：6.22，95%CI：1.90-20.36）。抗肿瘤坏死因子（TNF）与更严重的结局无关。
年龄、新发胃肠道症状和 5-ASA 的使用与 IBD 患者的住院率增加相关，而抗 TNF 治疗与 COVID-19 结局无统计学关联。
