Systematic Review on Inflammatory Bowel Disease Patients With Coronavirus Disease 2019: It Is Time to Take Stock.
Systematic Review on Inflammatory Bowel Disease Patients With Coronavirus Disease 2019: It Is Time to Take Stock.
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DOI：
10.1016/j.cgh.2020.08.003
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Peyrin-Biroulet L
中科院分区：
文献类型：
--
作者：
D'Amico F;Danese S;Peyrin-Biroulet L
关于2019冠状病毒病（COVID-19）炎症性肠病（IBD）患者临床特征的数据很少。我们的系统性综述的目的是调查COVID-19 IBD患者的症状和诊断-治疗管理。我们检索了截至2020年7月29日的PubMed、Embase、Web of Science和MedRxiv，以确定所有报告确诊COVID-19的成人和儿童IBD患者临床信息的研究。23项研究符合我们的纳入标准，包括243，760例IBD患者。在1028名患者中诊断出COVID-19（509名克罗恩病[49.5%]，428名溃疡性结肠炎[41.6%]，49名不确定性结肠炎[4.8%]，42名数据缺失[4.1%]），累积患病率为0.4%。病毒感染发生在男性比女性更频繁（56.5%比39.7%），平均年龄范围为14至85岁。最常见的症状是发热（48.3%）、咳嗽（46.5%）和腹泻（20.5%），COVID-19的诊断主要通过鼻咽拭子的聚合酶链反应分析（94.4%）和胸部计算机断层扫描（38.9%）实现。使用最多的药物是羟氯喹（23.9%）、洛匹那韦/利托那韦（8.2%）、类固醇（3.2%）和抗生素（3.1%）。总体而言，约三分之一的患者住院（30.6%），其中11.4%需要入住重症监护室。共报告了29例COVID-19相关死亡（3.8%），年龄增加和合并症的存在被认为是COVID-19和负面结局的风险因素。腹泻在感染COVID-19的IBD患者中的发生率高于非IBD人群。需要进一步研究来确定COVID-19 IBD患者的最佳诊断-治疗方法。
Data on the clinical characteristics of patients with inflammatory bowel diseases (IBDs) with coronavirus disease 2019 (COVID-19) are scarce. The aim of our systematic review was to investigate symptoms and diagnostic–therapeutic management of IBD patients with COVID-19. We searched PubMed, Embase, Web of Science, and MedRxiv up to July 29, 2020, to identify all studies reporting clinical information on adult and pediatric IBD patients with confirmed COVID-19. Twenty-three studies met our inclusion criteria, including 243,760 IBD patients. COVID-19 was diagnosed in 1028 patients (509 with Crohn’s disease [49.5%], 428 with ulcerative colitis [41.6%], 49 with indeterminate colitis [4.8%], and 42 with missing data [4.1%]), accounting for a cumulative prevalence of 0.4%. Viral infection occurred more frequently in males than in females (56.5% vs 39.7%), and the mean age ranged from 14 to 85 years. The most common symptoms were fever (48.3%), cough (46.5%), and diarrhea (20.5%), and a COVID-19 diagnosis was achieved mainly through polymerase chain reaction analysis of nasopharyngeal swabs (94.4%) and chest computed tomography scans (38.9%). Hydroxychloroquine (23.9%), lopinavir/ritonavir (8.2%), steroids (3.2%), and antibiotics (3.1%) were the most used drugs. Overall, approximately a third of patients were hospitalized (30.6%), and 11.4% of them required admission to the intensive care unit. In total, 29 COVID-19–related deaths were reported (3.8%), and increasing age and the presence of comorbidities were recognized as risk factors for COVID-19 and negative outcomes. Diarrhea occurs more frequently in IBD patients with COVID-19 than in the non-IBD population. Further studies are needed to define the optimal diagnostic–therapeutic approach in IBD patients with COVID-19.
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作者：
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DOI：
10.1097/mpg.0000000000002809
发表时间：
2020-08-01
影响因子：
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作者：
Dolinger, Michael T.;Person, Hannibal;Lai, Joanne
通讯作者：
Lai, Joanne