Nakase Hiroshi, Hayashi Yuki, Yokoyama Yoshihiro, Matsumoto Takayuki, Matsuura Minoru, Iijima Hideki, Matsuoka Katsuyoshi, Ohmiya Naoki, Ishihara Shunji, Hirai Fumihito, Abukawa Daiki, Hisamatsu Tadakazu
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan.
Division of Gastroenterology, Department of Medicine, Iwate Medical University, Morioka, Japan.
Gastro Hep Adv. 2023 Jul 31;2(8):1056-1065. doi: 10.1016/j.gastha.2023.07.017. eCollection 2023.
Japan has experienced 8 waves of the coronavirus disease 2019 (COVID-19) outbreak over the past 3 years, resulting in an increasing number of deaths and incidence of severe infections. This study aimed to analyze the data from the Japanese inflammatory bowel disease (IBD) patients with COVID-19 registry (J-COSMOS) up to the eighth wave to investigate the clinical course of IBD patients with COVID-19 and factors contributing to disease severity.
In this multicenter, observational, cohort study, we analyzed a cohort of 1308 IBD patients diagnosed with COVID-19, enrolled across 77 participating facilities in the J-COSMOS registry from June 2020 to December 2022. Data on age, sex, IBD (classification, treatment, and activity), and COVID-19 (symptoms, severity, and treatment) were analyzed.
The majority of patients (76%) were in clinical remission. According to the World Health Organization classification of COVID-19 severity, 98.4% of IBD patients had nonsevere disease, while 1.6% of patients had severe or critical disease. COVID-19 did not affect disease activity in most IBD patients. Stepwise logistic regression analysis revealed that high body mass index, and cerebrovascular disease were risk factors for severe COVID-19. Corticosteroids could affect COVID-19 severity, whereas anti-tumor necrosis factor α antibodies and thiopurines were associated with a reduced risk of severe COVID-19. No deaths were observed among IBD patients with COVID-19 registered in this cohort.
The impact of COVID-19 on IBD disease activity and factors associated with COVID-19 severity were consistent with findings of previous reports. No deaths in Japanese patients with IBD were observed.
在过去3年里，日本经历了8波2019冠状病毒病（COVID-19）疫情，导致死亡人数增加，严重感染发病率上升。本研究旨在分析日本炎症性肠病（IBD）合并COVID-19登记系统（J-COSMOS）截至第八波疫情的数据，以调查IBD合并COVID-19患者的临床病程及导致疾病严重程度的因素。
在这项多中心、观察性队列研究中，我们分析了2020年6月至2022年12月期间在J-COSMOS登记系统中77个参与机构登记的1308例诊断为COVID-19的IBD患者队列。分析了年龄、性别、IBD（分类、治疗和活动情况）以及COVID-19（症状、严重程度和治疗情况）的数据。
大多数患者（76%）处于临床缓解期。根据世界卫生组织对COVID-19严重程度的分类，98.4%的IBD患者患有非重症疾病，而1.6%的患者患有重症或危重症疾病。COVID-19在大多数IBD患者中未影响疾病活动。逐步逻辑回归分析显示，高体重指数和脑血管疾病是重症COVID-19的危险因素。皮质类固醇可能影响COVID-19的严重程度，而抗肿瘤坏死因子α抗体和硫唑嘌呤与重症COVID-19风险降低相关。在该队列登记的IBD合并COVID-19患者中未观察到死亡病例。
COVID-19对IBD疾病活动的影响以及与COVID-19严重程度相关的因素与既往报道结果一致。未观察到日本IBD患者死亡。
