tetano
Editor, Senior Moderator
Inflamm Bowel Dis
. 2022 Apr 6;izac064.
doi: 10.1093/ibd/izac064. Online ahead of print.
Severe Activity of Inflammatory Bowel Disease is a Risk Factor for Severe COVID-19
Fabio Salvatore Macaluso[SUP] 1 [/SUP], Alessandra Giuliano[SUP] 1 [/SUP], Walter Fries[SUP] 2 [/SUP], Anna Viola[SUP] 2 [/SUP], Alfredo Abbruzzese[SUP] 2 [/SUP], Maria Cappello[SUP] 3 [/SUP], Enrica Giuffrida[SUP] 3 [/SUP], Lucio Carrozza[SUP] 3 [/SUP], Antonino Carlo Privitera[SUP] 4 [/SUP], Antonio Magnano[SUP] 5 [/SUP], Concetta Ferracane[SUP] 5 [/SUP], Giuseppe Scalisi[SUP] 6 [/SUP], Maria Giovanna Minissale[SUP] 7 [/SUP], Emiliano Giangreco[SUP] 8 [/SUP], Serena Garufi[SUP] 9 [/SUP], Carmelo Bertolami[SUP] 10 [/SUP], Ugo Cucinotta[SUP] 11 [/SUP], Francesco Graziano[SUP] 11 12 [/SUP], Angelo Casà[SUP] 1 [/SUP], Sara Renna[SUP] 1 [/SUP], Giulia Teresi[SUP] 1 [/SUP], Giulia Rizzuto[SUP] 1 [/SUP], Mariella Mannino[SUP] 1 [/SUP], Marcello Maida[SUP] 10 [/SUP], Ambrogio Orlando[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Data from the first wave of the coronavirus disease 2019 (COVID-19) pandemic suggested that patients with inflammatory bowel disease (IBD) are not at higher risk of being infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and that a worse prognosis is not associated with immunomodulatory drugs, with the possible exception of systemic steroids.
Methods: This retrospective, observational study included consecutive IBD patients from the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) cohort who had a SARS-CoV-2 infection diagnosis (polymerase chain reaction-confirmed presence of the viral genome in a nasopharyngeal swab) during the second COVID-19 pandemic wave (September 2020 to December 2020). Data regarding demographics, IBD features and treatments, and comorbidities were analyzed in correlation with COVID-19 clinical outcomes.
Results: Data on 122 patients (mean age, 43.9 ± 16.7 years; males, 50.0%; Crohn's disease, 62.3%; ulcerative colitis, 37.7%) were reported. Twelve patients developed COVID-19-related pneumonia (9.8%), 4 (3.3%) required respiratory assistance (nonmechanical ventilation or orotracheal intubation), and 4 died (case fatality rate, 3.3%). In a multivariable analysis, age (odds ratio [OR], 1.034; 95% CI, 1.006-1.147; P = .032) and severe IBD activity (OR, 13.465; 95% CI, 1.104-164.182; P = .042) were independent predictors of COVID-19-related pneumonia, while severe IBD activity (OR, 15.359; 95% CI, 1.320-178.677; P = .030) was the only independent predictor of severe COVID-19, a composite endpoint defined as the need for respiratory assistance or death. A trend towards a protective role of tumor necrosis factor α inhibitors on pneumonia development was reported (P = .076).
Conclusions: In this cohort of patients with IBD and SARS-CoV-2 infection, severe IBD activity was the only independent risk factor for severe COVID-19.
Keywords: 2; CoV; IBD; SARS; SN; biologics; immunosuppression.
. 2022 Apr 6;izac064.
doi: 10.1093/ibd/izac064. Online ahead of print.
Severe Activity of Inflammatory Bowel Disease is a Risk Factor for Severe COVID-19
Fabio Salvatore Macaluso[SUP] 1 [/SUP], Alessandra Giuliano[SUP] 1 [/SUP], Walter Fries[SUP] 2 [/SUP], Anna Viola[SUP] 2 [/SUP], Alfredo Abbruzzese[SUP] 2 [/SUP], Maria Cappello[SUP] 3 [/SUP], Enrica Giuffrida[SUP] 3 [/SUP], Lucio Carrozza[SUP] 3 [/SUP], Antonino Carlo Privitera[SUP] 4 [/SUP], Antonio Magnano[SUP] 5 [/SUP], Concetta Ferracane[SUP] 5 [/SUP], Giuseppe Scalisi[SUP] 6 [/SUP], Maria Giovanna Minissale[SUP] 7 [/SUP], Emiliano Giangreco[SUP] 8 [/SUP], Serena Garufi[SUP] 9 [/SUP], Carmelo Bertolami[SUP] 10 [/SUP], Ugo Cucinotta[SUP] 11 [/SUP], Francesco Graziano[SUP] 11 12 [/SUP], Angelo Casà[SUP] 1 [/SUP], Sara Renna[SUP] 1 [/SUP], Giulia Teresi[SUP] 1 [/SUP], Giulia Rizzuto[SUP] 1 [/SUP], Mariella Mannino[SUP] 1 [/SUP], Marcello Maida[SUP] 10 [/SUP], Ambrogio Orlando[SUP] 1 [/SUP]
Affiliations
- PMID: 35385102
- DOI: 10.1093/ibd/izac064
Abstract
Background: Data from the first wave of the coronavirus disease 2019 (COVID-19) pandemic suggested that patients with inflammatory bowel disease (IBD) are not at higher risk of being infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and that a worse prognosis is not associated with immunomodulatory drugs, with the possible exception of systemic steroids.
Methods: This retrospective, observational study included consecutive IBD patients from the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) cohort who had a SARS-CoV-2 infection diagnosis (polymerase chain reaction-confirmed presence of the viral genome in a nasopharyngeal swab) during the second COVID-19 pandemic wave (September 2020 to December 2020). Data regarding demographics, IBD features and treatments, and comorbidities were analyzed in correlation with COVID-19 clinical outcomes.
Results: Data on 122 patients (mean age, 43.9 ± 16.7 years; males, 50.0%; Crohn's disease, 62.3%; ulcerative colitis, 37.7%) were reported. Twelve patients developed COVID-19-related pneumonia (9.8%), 4 (3.3%) required respiratory assistance (nonmechanical ventilation or orotracheal intubation), and 4 died (case fatality rate, 3.3%). In a multivariable analysis, age (odds ratio [OR], 1.034; 95% CI, 1.006-1.147; P = .032) and severe IBD activity (OR, 13.465; 95% CI, 1.104-164.182; P = .042) were independent predictors of COVID-19-related pneumonia, while severe IBD activity (OR, 15.359; 95% CI, 1.320-178.677; P = .030) was the only independent predictor of severe COVID-19, a composite endpoint defined as the need for respiratory assistance or death. A trend towards a protective role of tumor necrosis factor α inhibitors on pneumonia development was reported (P = .076).
Conclusions: In this cohort of patients with IBD and SARS-CoV-2 infection, severe IBD activity was the only independent risk factor for severe COVID-19.
Keywords: 2; CoV; IBD; SARS; SN; biologics; immunosuppression.