Alsakarneh Saqr, Ramirez Ramirez Oscar, Hayney Mary S, Hashash Jana G, Farraye Francis A, Caldera Freddy
Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA.
Department Medicine, Division of Internal Medicine, University of Wisconsin-Madison School of Medicine & Public Health, Madison, Wisconsin, USA.
Clin Transl Gastroenterol. 2025 May 1;16(5):e00840. doi: 10.14309/ctg.0000000000000840.
Patients with inflammatory bowel disease (IBD) are at an increased risk of infections. Before the COVID-19 pandemic, respiratory syncytial virus (RSV) followed predictable seasonal patterns, which have been recently disrupted. This study aimed to investigate whether severe acute respiratory syndrome (SARS) coronavirus 2 (CoV-2) infection is associated with an increased risk of RSV infection in patients with IBD compared with those without a history of SARS-CoV-2 infection.
This retrospective cohort study used the TriNetX database to identify patients aged 18 years and older with IBD and SARS-CoV-2 infection (IBD-SARS-CoV-2 cohort) during the 2022 and 2023 RSV seasons. A 1:1 propensity score matching was used to compare patients with IBD but no history of SARS-CoV-2 infection (IBD non-SARS-CoV-2 cohort).
In the 2022 IBD-SARS-CoV-2 cohort (mean age: 53.7 ± 17.6 years; 59% female; 77% White), the RSV infection risk was 0.47%, higher than 0.19% in the matched IBD non-SARS-CoV-2 cohort (adjusted odds ratio [aOR]: 2.4; 95% CI: 1.5-3.6). The risk was highest 30-60 days after SARS-CoV-2 infection (aOR: 2.9; 95% CI: 1.7-4.9), particularly in those aged 60 years and older (aOR: 2.5; 95% CI: 1.3-4.5). The use of systemic corticosteroids (aOR: 2.3; 95% CI: 1.1-4.6) or immune-modifying therapies (aOR: 3.9; 95% CI: 2-7.1) was associated with higher RSV infection risk. Similar trends were observed during the 2023 RSV season, with no significant differences in RSV-related hospitalizations.
Adults with IBD have a higher risk of RSV infection after SARS-CoV-2 infection, particularly those receiving steroids or immune therapies. SARS-CoV-2 infection may have contributed to the recent RSV infection surge in this population, warranting further research.
炎症性肠病（IBD）患者感染风险增加。在2019冠状病毒病（COVID-19）大流行之前，呼吸道合胞病毒（RSV）遵循可预测的季节性模式，但最近这种模式被打乱了。本研究旨在调查与无2019冠状病毒（SARS-CoV-2）感染史的患者相比，SARS-CoV-2感染是否与IBD患者RSV感染风险增加相关。
这项回顾性队列研究使用TriNetX数据库，确定2022年和2023年RSV流行季节期间18岁及以上患有IBD和SARS-CoV-2感染的患者（IBD-SARS-CoV-2队列）。采用1:1倾向评分匹配法，比较患有IBD但无SARS-CoV-2感染史的患者（IBD非SARS-CoV-2队列）。
在2022年IBD-SARS-CoV-2队列中（平均年龄：53.7±17.6岁；59%为女性；77%为白人），RSV感染风险为0.47%，高于匹配的IBD非SARS-CoV-2队列中的0.19%（调整后的优势比[aOR]：2.4；95%置信区间[CI]：1.5-3.6）。SARS-CoV-2感染后30-60天风险最高（aOR：2.9；95%CI：1.7-4.9），尤其是60岁及以上的患者（aOR：2.5；95%CI：1.3-4.5）。使用全身性皮质类固醇（aOR：2.3；95%CI：1.1-4.6）或免疫调节疗法（aOR：3.9；95%CI：2-7.1）与较高的RSV感染风险相关。在2023年RSV流行季节观察到类似趋势，RSV相关住院率无显著差异。
患有IBD的成年人在感染SARS-CoV-2后感染RSV的风险更高，尤其是那些接受类固醇或免疫疗法的患者。SARS-CoV-2感染可能是该人群近期RSV感染激增的原因之一，值得进一步研究。
