The natural history of COVID-19 in patients with inflammatory bowel disease: a nationwide study by the Hellenic Society for the study of IBD.
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Bamias Giorgos, Kokkotis Georgios, Christidou Angeliki, Christodoulou Dimitrios K, Delis Vasileios, Diamantopoulou Georgia, Fessatou Smaragdi, Gatopoulou Anthia, Giouleme Olga, Kafritsa Panagiota, Kalantzis Chrisostomos, Kapsoritakis Andreas, Karatzas Pantelis, Karmiris Konstantinos, Katsanos Konstantinos, Kevrekidou Polyxeni, Kosmidis Charalampos, Mantaka Aikaterini, Mathou Nicoletta, Michalopoulos George, Michopoulos Spyridon, Papaconstantinou Ioannis, Papatheodoridis George, Polymeros Dimitrios, Potamianos Spyros, Poulopoulos Georgios, Protopapas Andreas, Sklavaina Maria, Soufleris Konstantinos, Theocharis Georgios, Theodoropoulou Angeliki, Triantafillidis John K, Triantafyllou Konstantinos, Tsiolakidou Georgia, Tsironi Eftychia, Tzouvala Maria, Viazis Nikos, Xourgias Vasileios, Zacharopoulou Eirini, Zampeli Evanthia, Mantzaris Gerasimos J
Аннотация
METHODS: Following a national call from the Hellenic Society for the study of IBD, we enrolled all IBD patients with established diagnoses of COVID-19. Clinical and epidemiological data, including COVID-19 modifying factors and IBD-associated therapies, were analyzed against adverse outcomes (hospitalization, ICU admission and death).
RESULTS: We identified 154 IBD patients who were diagnosed with COVID-19 (men: 58.4%; mean age=41.7 years [SD = 14.9]; CD: 64.3%). Adverse outcomes were reported in 34 patients (22.1%), including 3 ICU admissions (1.9%) and two deaths (1.3%). Multivariate logistic regression analysis showed that age (OR = 1.04, 95% CI, 1-1.08) and dyspnea at presentation (OR = 7.36, 95% CI, 1.84-29.46) were associated with worse outcomes of COVID-19 infection. In contrast, treatment with biologics, in particular anti-TNF agents, exerted a protective effect against an unfavorable COVID-19 disease course (OR = 0.4, 95% CI, 0.16-0.99). Patients on subcutaneous biologics were more likely to halt treatment due to the infection as compared to those on intravenous biologics.
CONCLUSIONS: IBD patients who developed COVID-19 had a benign course with adverse outcomes being infrequent. Treatment with anti-TNF biologics had a protective effect, thus, supporting continuation of therapy during the pandemic.