Patients with Inflammatory Bowel Disease Are Not at Increased Risk of COVID-19: A Large Multinational Cohort Study

M. Allocca; M. Chaparro; H. Gonzalez; M. Bosca-Watts; C. Palmela; F. D’Amico; E. Zacharopoulou; U. Kopylov; P. Ellul; G. Bamias; V. Ntelis; A. Lahat; G. Mantzaris; I. Papaconstantinou; K. Katsanos; Y. Uspenskaya; D. Christodoulou; S. Horin; L. Peyrin-Biroulet; J. Torres; S. Sebastian; J. Gisbert; S. Danese; G. Fiorino

Статья

Patients with Inflammatory Bowel Disease Are Not at Increased Risk of COVID-19: A Large Multinational Cohort Study

M. Allocca, M. Chaparro, H. Gonzalez, M. Bosca-Watts, C. Palmela, F. D’Amico, E. Zacharopoulou, U. Kopylov, P. Ellul, G. Bamias, V. Ntelis, A. Lahat, G. Mantzaris, I. Papaconstantinou, K. Katsanos, Y. Uspenskaya, D. Christodoulou, S. Horin, L. Peyrin-Biroulet, J. Torres, S. Sebastian, J. Gisbert, S. Danese, G. Fiorino,

2020

https://doi.org/10.3390/jcm9113533

The impact of COVID-19 on inflammatory bowel disease (IBD) patients under pharmacological immunosuppression is still not clearly understood. We investigated the incidence of COVID-19 and the impact of immunosuppression and containment measures on the risk of SARS-CoV-2 infection in a large IBD cohort, from a multicenter cohort from 21st of February to 30th of June, 2020. Ninety-seven patients with IBD (43 UC, 53 CD, one unclassified IBD) and concomitant COVID-19 over a total of 23,879 patients with IBD were enrolled in the study. The cumulative incidence of SARS-CoV-2 infection in patients with IBD vs. the general population was 0.406% and 0.402% cases, respectively. Twenty-three patients (24%) were hospitalized, 21 (22%) had pneumonia, four (4%) were admitted to the Intensive Care Unit, and one patient died. Lethality in our cohort was 1% compared to 9% in the general population. At multivariable analysis, age > 65 years was associated with increased risk of pneumonia and hospitalization (OR 11.6, 95% CI 2.18-62.60; OR 5.1, 95% CI 1.10-23.86, respectively), treatment with corticosteroids increased the risk of hospitalization (OR 7.6, 95% CI 1.48-40.05), whereas monoclonal antibodies were associated with reduced risk of pneumonia and hospitalization (OR 0.1, 95% CI 0.04-0.52; OR 0.3, 95% CI 0.10-0.90, respectively). The risk of COVID-19 in patients with IBD is similar to the general population. National lockdown was effective in preventing infection in our cohort. Advanced age and treatment with corticosteroids impacted negatively on the outcome of COVID-19, whereas monoclonal antibodies did not seem to have a detrimental effect.

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1. Version of Record от 2020-10-31

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Об авторах

M. Allocca
Humanitas Clinical and Research Center–IRCCS-, via Manzoni 56, 20089 Rozzano, Milan, Italy;, eirinizachar@gmail.com, (E.Z.);, sdanese@hotmail.com, (S.D.), Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy;, ferdinando.damico@humanitas.it, (F.D.);, gionataf@gmail.com, (G.F.)
M. Chaparro
Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28001 Madrid, Spain;, mariachs2005@gmail.com, (M.C.);, javier.p.gisbert@gmail.com, (J.P.G.)
H. Gonzalez
IBD Unit, Hull University Hospitals NHS Trust, Hull HU1, UK;, haidee.gonzalez@hey.nhs.uk, (H.A.G.);, shaji.sebastian@hey.nhs.uk, (S.S.)
M. Bosca-Watts
IBD Unit, Digestive Disease Department, University of Valencia, University Clinic Hospital of Valencia, 46010 València, Spain;, maiabosca@yahoo.es
C. Palmela
Division of Gastroenterology, Hospital Beatriz Ângelo, 2620 Loures, Portugal;, palmela.carolina@gmail.com, (C.P.);, joanatorres00@gmail.com, (J.T.)
F. D’Amico
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy;, ferdinando.damico@humanitas.it, (F.D.);, gionataf@gmail.com, (G.F.), Department of Gastroenterology, Inserm U1256 NGERE, Nancy University Hospital, Lorraine University, 54500 Vandoeuvre-les-Nancy, France;, peyrinbiroulet@gmail.com
E. Zacharopoulou
Humanitas Clinical and Research Center–IRCCS-, via Manzoni 56, 20089 Rozzano, Milan, Italy;, eirinizachar@gmail.com, (E.Z.);, sdanese@hotmail.com, (S.D.)
U. Kopylov
Department of Gastroenterology, Sheba Medical Center, Ramat Gan and Sackler School of Medicine, Tel Aviv University, Jaffa 59623, Israel;, ukopylov@gmail.com, (U.K.);, zokadi@gmail.com, (A.L.);, shomron.benhorin@gmail.com, (S.B.H.)
P. Ellul
Division of Gastroenterology, Mater Dei Hospital, MT-34 Msida, Malta;, ellul.pierre@gmail.com
G. Bamias
GI-Unit, 3rd Academic Department of Internal Medicine, Sotiria Hospital, Medical School, National and Kapodistrian University of Athens, 210 Athens, Greece;, gbamias@gmail.com
V. Ntelis
G.Gennimatas General Hospital, 210 Athens, Greece;, basildelis@yahoo.gr
A. Lahat
Department of Gastroenterology, Sheba Medical Center, Ramat Gan and Sackler School of Medicine, Tel Aviv University, Jaffa 59623, Israel;, ukopylov@gmail.com, (U.K.);, zokadi@gmail.com, (A.L.);, shomron.benhorin@gmail.com, (S.B.H.)
G. Mantzaris
Department of Gastroenterology, GHA Evaggelismos-Ophthalmiatreion Athinon-Polykliniki, 210 Athens, Greece;, gjmantzaris@gmail.com
I. Papaconstantinou
Academic Department of Surgery, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 210 Athens, Greece;, johnpapacon@hotmail.com
K. Katsanos
Division of Gastroenterology, University Hospital and University of Ioannina, 440 Ioannina, Greece;, khkostas@hotmail.com, (K.K.);, dchristodoulou@gmail.com, (D.C.)
Y. Uspenskaya
Medical Center “Ne Bolit” LTT, Leninsky Prospect, 66 Moscow, Russia;, jusp@mail.ru
D. Christodoulou
Division of Gastroenterology, University Hospital and University of Ioannina, 440 Ioannina, Greece;, khkostas@hotmail.com, (K.K.);, dchristodoulou@gmail.com, (D.C.)
S. Horin
Department of Gastroenterology, Sheba Medical Center, Ramat Gan and Sackler School of Medicine, Tel Aviv University, Jaffa 59623, Israel;, ukopylov@gmail.com, (U.K.);, zokadi@gmail.com, (A.L.);, shomron.benhorin@gmail.com, (S.B.H.)
L. Peyrin-Biroulet
Department of Gastroenterology, Inserm U1256 NGERE, Nancy University Hospital, Lorraine University, 54500 Vandoeuvre-les-Nancy, France;, peyrinbiroulet@gmail.com
J. Torres
Division of Gastroenterology, Hospital Beatriz Ângelo, 2620 Loures, Portugal;, palmela.carolina@gmail.com, (C.P.);, joanatorres00@gmail.com, (J.T.)
S. Sebastian
IBD Unit, Hull University Hospitals NHS Trust, Hull HU1, UK;, haidee.gonzalez@hey.nhs.uk, (H.A.G.);, shaji.sebastian@hey.nhs.uk, (S.S.)
J. Gisbert
Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28001 Madrid, Spain;, mariachs2005@gmail.com, (M.C.);, javier.p.gisbert@gmail.com, (J.P.G.)
S. Danese
Humanitas Clinical and Research Center–IRCCS-, via Manzoni 56, 20089 Rozzano, Milan, Italy;, eirinizachar@gmail.com, (E.Z.);, sdanese@hotmail.com, (S.D.), Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy;, ferdinando.damico@humanitas.it, (F.D.);, gionataf@gmail.com, (G.F.)
G. Fiorino
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy;, ferdinando.damico@humanitas.it, (F.D.);, gionataf@gmail.com, (G.F.)

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Journal of Clinical Medicine

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3533

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Patients with Inflammatory Bowel Disease Are Not at Increased Risk of COVID-19: A Large Multinational Cohort Study

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