Background: Older age and comorbidities are the main risk factors for adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims: To assess risk factors for adverse outcomes of COVID-19 in IBD patients and use the identified risk factors to build risk indices. Methods: Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results: Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS-CoV-2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID-19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune-mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID-19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID-19 outcomes, but anti-TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID-19 in CD. Conclusion: The course of COVID-19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID-19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID-19 re-vaccination or for therapies for SARS-CoV-2 infection.
Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study / Bezzio, C.; Armuzzi, A.; Furfaro, F.; Ardizzone, S.; Milla, M.; Carparelli, S.; Orlando, A.; Caprioli, F. A.; Castiglione, F.; Vigano, C.; Ribaldone, D. G.; Zingone, F.; Monterubbianesi, R.; Imperatore, N.; Festa, S.; Daperno, M.; Scucchi, L.; Ferronato, A.; Pastorelli, L.; Balestrieri, P.; Ricci, C.; Cappello, M.; Felice, C.; Fiorino, G.; Saibeni, S.; Coppini, F.; Alvisi, P.; Gerardi, V.; Variola, A.; Mazzuoli, S.; Lenti, M. V.; Pugliese, D.; Allocca, M.; Ferretti, F.; Roselli, J.; Bossa, F.; Giuliano, A.; Piazza, N.; Manes, G.; Sartini, A.; Buda, A.; Micheli, F.; Ciardo, V.; Casella, G.; Viscido, A.; Bodini, G.; Casini, V.; Soriano, A.; Amato, A.; Grossi, L.; Onali, S.; Rottoli, M.; Spagnuolo, R.; Baroni, S.; Cortelezzi, C. C.; Baldoni, M.; Vernero, M.; Scaldaferri, F.; Maconi, G.; Guarino, A. D.; Palermo, A.; D'Inca, R.; Scribano, M. L.; Biancone, L.; Carrozza, L.; Ascolani, M.; Costa, F.; Di Sabatino, A.; Zammarchi, I.; Gottin, M.; Conforti, F. S.. - In: ALIMENTARY PHARMACOLOGY & THERAPEUTICS. - ISSN 0269-2813. - 54:11-12(2021), pp. 1432-1441. [10.1111/apt.16663]
Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study
Furfaro F.;Casella G.;Amato A.;Costa F.;
2021-01-01
Abstract
Background: Older age and comorbidities are the main risk factors for adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims: To assess risk factors for adverse outcomes of COVID-19 in IBD patients and use the identified risk factors to build risk indices. Methods: Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results: Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS-CoV-2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID-19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune-mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID-19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID-19 outcomes, but anti-TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID-19 in CD. Conclusion: The course of COVID-19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID-19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID-19 re-vaccination or for therapies for SARS-CoV-2 infection.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
