Division of Gastroenterology, Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
Department of Internal Medicine, Ankara University Faculty of Medicine, Ankara, Turkey.
Turk J Gastroenterol. 2022 Dec;33(12):1025-1032. doi: 10.5152/tjg.2022.22059.
Coronavirus disease-2019 has become a serious pandemic, and still remains a risk despite vaccines that have been devel- oped. Among inflammatory bowel disease patients old age, inflammatory bowel disease activation, the existence of the comorbid dis- ease, and using steroids are known risk factors for severe coronavirus disease-2019. But there are different data for drugs other than corticosteroids used. The aims of the study are to evaluate the prevalence and risk factors of severe coronavirus disease-2019 and the effect of inflammatory bowel disease drugs on severe coronavirus disease-2019.
In this study among 1195 inflammatory bowel disease patients, 130 patients who were found to be positive for severe acute respiratory syndrome coronavirus-2 between March 2020 and May 2021 were evaluated. Patients were divided into 3 groups as mild, moderate, and severe coronavirus disease-2019.
Among 130 patients, 91 (70%) had mild, 16 (12.3%) had moderate, and 23 (17.7%) had severe coronavirus disease-2019. Being 60 years of age or older (P = .009), having at least 1 comorbid disease (P = .002), and having active inflammatory bowel disease (P = .001) were factors that increased the risk for severe coronavirus disease-2019. The use of mesalazine (P = .35), biologic agents (P = .23), and corticosteroids (P = .42) did not increase the risk of severe coronavirus disease-2019. The use of azathioprine seemed to decrease the risk of severe disease with univariate regression analysis however the significance disappeared with multivariate analysis.
Older age, active inflammatory bowel disease, and existence of at least 1 comorbid disease are risk factors for severe coro- navirus disease-2019. However, drugs used in inflammatory bowel disease management do not increase the risk of severe coronavirus disease-2019. But due to the small number of patients, it is difficult to reach a definite conclusion about corticosteroids.
新冠肺炎已成为严重的大流行病，尽管已经开发出疫苗，但仍存在风险。在老年、炎症性肠病活动、合并症存在和使用类固醇的炎症性肠病患者中，这些是新冠肺炎重症的已知危险因素。但是，皮质类固醇以外的其他药物的数据不同。本研究的目的是评估新冠肺炎重症的患病率和危险因素，以及炎症性肠病药物对新冠肺炎重症的影响。
在这项对 1195 名炎症性肠病患者的研究中，评估了 2020 年 3 月至 2021 年 5 月期间发现的 130 例严重急性呼吸综合征冠状病毒-2 阳性患者。患者分为三组：轻症、中度和重症新冠肺炎。
在 130 例患者中，91 例（70%）为轻症，16 例（12.3%）为中度，23 例（17.7%）为重症新冠肺炎。年龄在 60 岁或以上（P=0.009）、至少合并一种合并症（P=0.002）和炎症性肠病活动（P=0.001）是新冠肺炎重症的危险因素。使用美沙拉嗪（P=0.35）、生物制剂（P=0.23）和皮质类固醇（P=0.42）并未增加新冠肺炎重症的风险。单变量回归分析显示，使用硫唑嘌呤似乎降低了重症疾病的风险，但多变量分析显示该结果无统计学意义。
年龄较大、炎症性肠病活动和至少合并一种合并症是新冠肺炎重症的危险因素。然而，炎症性肠病管理中使用的药物并不会增加新冠肺炎重症的风险。但是，由于患者人数较少，关于皮质类固醇的结论还很难确定。
