Section of Digestive Diseases, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA.
Division of Gastroenterology and Hepatology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA.
Dig Dis Sci. 2024 May;69(5):1654-1660. doi: 10.1007/s10620-024-08355-3. Epub 2024 Mar 11.
While there are multiple safe and effective agents for COVID-19 treatment, their impact in inflammatory bowel disease (IBD) remains uncertain.
Our objective was to assess the effects of these therapies on both IBD and COVID outcomes.
A single-center retrospective study of adult patients with IBD who contracted COVID-19 between 12/2020 and 11/2022 was performed. Patients were stratified by COVID-19 treatment (antivirals and/or intravenous antibodies) vs no therapy. The primary outcome was the development of severe COVID-19 infection, defined by need for supplemental oxygen, corticosteroids and/or antibiotics, or hospitalization. Secondary outcomes included rates of withholding advanced IBD therapy (defined as biologic agents or small molecules) and of post-COVID-19 IBD flare.
Of 127 patients with COVID-19 infection, 70% were on advanced therapies, 35% received COVID-19 treatment, and 15% developed severe COVID-19. Those treated for COVID-19 were more likely to be on corticosteroids [odds ratio (OR) 4.61, 95% confidence interval (CI) 1.72-12.39, p = 0.002] or advanced IBD therapies (OR 2.78, 95% CI 1.04-7.43, p = 0.041). After adjusting for age, race, sex, corticosteroid use, obesity, COVID-19 vaccination status, and severe COVID-19 infection, those treated for COVID-19 were more likely to have IBD therapy held (OR 6.95, 95% CI 1.72-28.15, p = 0.007). There was no significant difference in rates of post-COVID-19 IBD flares or severe COVID-19 infection. There were no COVID-related deaths.
Patients with IBD on advanced therapies were frequently treated for acute COVID-19. Although COVID-19 treatment was associated with temporary withholding of IBD therapy, it did not result in increased IBD flares.
虽然有多种安全有效的 COVID-19 治疗药物，但它们在炎症性肠病 (IBD) 中的作用尚不确定。
我们的目的是评估这些疗法对 IBD 和 COVID 结局的影响。
对 2020 年 12 月至 2022 年 11 月期间患有 IBD 且感染 COVID-19 的成年患者进行了一项单中心回顾性研究。根据 COVID-19 治疗（抗病毒药物和/或静脉注射抗体）与无治疗对患者进行分层。主要结局是发生严重 COVID-19 感染，定义为需要补充氧气、皮质类固醇和/或抗生素或住院治疗。次要结局包括延迟 IBD 高级治疗（定义为生物制剂或小分子药物）的发生率和 COVID-19 后的 IBD 发作率。
在 127 名 COVID-19 感染患者中，70%正在接受高级治疗，35%接受 COVID-19 治疗，15%发生严重 COVID-19。接受 COVID-19 治疗的患者更有可能接受皮质类固醇治疗[比值比 (OR) 4.61，95%置信区间 (CI) 1.72-12.39，p=0.002]或接受 IBD 高级治疗（OR 2.78，95% CI 1.04-7.43，p=0.041）。在调整年龄、种族、性别、皮质类固醇使用、肥胖、COVID-19 疫苗接种状况和严重 COVID-19 感染后，接受 COVID-19 治疗的患者更有可能停止 IBD 治疗（OR 6.95，95% CI 1.72-28.15，p=0.007）。COVID-19 后 IBD 发作或严重 COVID-19 感染的发生率无显著差异。没有与 COVID 相关的死亡。
正在接受高级治疗的 IBD 患者经常接受急性 COVID-19 治疗。尽管 COVID-19 治疗与暂时停止 IBD 治疗相关，但并未导致 IBD 发作增加。
