Inflammatory Bowel Disease Unit, "Villa Sofia-Cervello" Hospital, Palermo, Italy.
Inflammatory Bowel Disease Unit, Policlinico "G. Martino," Messina, Italy.
Inflamm Bowel Dis. 2023 Feb 1;29(2):217-221. doi: 10.1093/ibd/izac064.
Data from the first wave of the coronavirus disease 2019 (COVID-19) pandemic suggested that patients with inflammatory bowel disease (IBD) are not at higher risk of being infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and that a worse prognosis is not associated with immunomodulatory drugs, with the possible exception of systemic steroids.
This retrospective, observational study included consecutive IBD patients from the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) cohort who had a SARS-CoV-2 infection diagnosis (polymerase chain reaction-confirmed presence of the viral genome in a nasopharyngeal swab) during the second COVID-19 pandemic wave (September 2020 to December 2020). Data regarding demographics, IBD features and treatments, and comorbidities were analyzed in correlation with COVID-19 clinical outcomes.
Data on 122 patients (mean age, 43.9 ± 16.7 years; males, 50.0%; Crohn's disease, 62.3%; ulcerative colitis, 37.7%) were reported. Twelve patients developed COVID-19-related pneumonia (9.8%), 4 (3.3%) required respiratory assistance (nonmechanical ventilation or orotracheal intubation), and 4 died (case fatality rate, 3.3%). In a multivariable analysis, age (odds ratio [OR], 1.034; 95% CI, 1.006-1.147; P = .032) and severe IBD activity (OR, 13.465; 95% CI, 1.104-164.182; P = .042) were independent predictors of COVID-19-related pneumonia, while severe IBD activity (OR, 15.359; 95% CI, 1.320-178.677; P = .030) was the only independent predictor of severe COVID-19, a composite endpoint defined as the need for respiratory assistance or death. A trend towards a protective role of tumor necrosis factor α inhibitors on pneumonia development was reported (P = .076).
In this cohort of patients with IBD and SARS-CoV-2 infection, severe IBD activity was the only independent risk factor for severe COVID-19.
来自 2019 年冠状病毒病（COVID-19）大流行第一波的数据表明，炎症性肠病（IBD）患者感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）的风险并不高于普通人群，且免疫调节剂药物与较差的预后无关，全身性类固醇除外。
这项回顾性观察性研究纳入了西西里炎症性肠病网络（SN-IBD）队列中的连续 IBD 患者，这些患者在第二次 COVID-19 大流行期间（2020 年 9 月至 2020 年 12 月）被诊断为 SARS-CoV-2 感染（经聚合酶链反应证实鼻咽拭子中存在病毒基因组）。分析了与 COVID-19 临床结果相关的人口统计学、IBD 特征和治疗以及合并症的数据。
报告了 122 名患者的数据（平均年龄 43.9±16.7 岁；男性 50.0%；克罗恩病 62.3%；溃疡性结肠炎 37.7%）。12 名患者发生 COVID-19 相关肺炎（9.8%），4 名（3.3%）需要呼吸支持（非机械通气或经口气管插管），4 名死亡（病死率，3.3%）。多变量分析显示，年龄（比值比[OR]，1.034；95%置信区间，1.006-1.147；P=0.032）和重度 IBD 活动（OR，13.465；95%置信区间，1.104-164.182；P=0.042）是 COVID-19 相关肺炎的独立预测因素，而重度 IBD 活动（OR，15.359；95%置信区间，1.320-178.677；P=0.030）是严重 COVID-19 的唯一独立预测因素，严重 COVID-19 的定义为需要呼吸支持或死亡的复合终点。报告 TNF-α 抑制剂对肺炎发生具有保护作用的趋势（P=0.076）。
在本队列中，患有 IBD 和 SARS-CoV-2 感染的患者中，重度 IBD 活动是严重 COVID-19 的唯一独立危险因素。
