Inflammatory Bowel Disease Clinical Activity is Associated with COVID-19 Severity Especially in Younger Patients.
Inflammatory Bowel Disease Clinical Activity is Associated with COVID-19 Severity Especially in Younger Patients.
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DOI：
10.1093/ecco-jcc/jjab172
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发表时间：
2022-05-10
期刊：
影响因子：
--
通讯作者：
Sebastian S
中科院分区：
文献类型：
--
作者：
Ricciuto A;Lamb CA;Benchimol EI;Walker GJ;Kennedy NA;Kuenzig ME;Kaplan GG;Kappelman MD;Ungaro RC;Colombel JF;Brenner EJ;Agrawal M;Reinisch W;Griffiths AM;Sebastian S
年龄是 COVID-19 结果的主要预后因素。炎症性肠病 [IBD] 活动对 COVID-19 的影响尚不清楚。我们根据年龄研究了 IBD 活动与 COVID-19 严重程度之间的关系。我们纳入了诊断为 COVID-19 的 IBD 患者，这些患者在 2020 年 3 月 13 日至 2021 年 8 月 3 日期间向 SECURE-IBD 报告。临床 IBD 活动通过医师总体评估 [PGA] 进行测量。 COVID-19 相关结局为 [1] 重症监护病房 [ICU] 入院、通气或死亡，以及 [2] 住院治疗。使用广义估计方程，我们确定了中度和重度 PGA 与临床缓解/轻度 PGA 的调整优势比 [aOR，95% 置信区间]，并控制了人口统计、药物治疗和 COVID-19 诊断期。我们按年龄[≤50 岁与>50 岁]进行分层分析。在 6078 名患者中，不良的 COVID-19 结局在活动性 IBD 中更为常见：ICU/通气/死亡的缓解/轻度患者为 3.6% [175/4898]，中度患者为 4.9% [45/920]，重度患者为 8.8% [23/260] [p < 0.001]；缓解/轻度住院率为 13% [649/4898]，中度缓解率为 19% [178/920]，重度住院率为 38% [100/260] [p < 0.001]。按十年分层，年轻患者的效应更大。在≤50岁的患者中，严重PGA与ICU/通气/死亡（aOR 3.27 [1.15–9.30]）和住院治疗（aOR 4.62 [2.83–7.55]）独立相关。相比之下，严重的 PGA 与 50 岁以上人群的 COVID-19 结局并不独立相关。临床活动性 IBD 可能是严重 COVID-19 的危险因素，特别是对于年轻患者。 IBD 疾病控制，包括通过药物依从性以及降低活动性 IBD 患者感染 COVID-19 风险的策略。保持距离、免疫]是限制 COVID-19 不良结果的关键。
Age is a major prognostic factor for COVID-19 outcomes. The effect of inflammatory bowel disease [IBD] activity on COVID-19 is unclear. We examined the relationship between IBD activity and COVID-19 severity according to age. We included IBD patients diagnosed with COVID-19, reported to SECURE-IBD between March 13, 2020 and August 3, 2021. Clinical IBD activity was measured by physician global assessment [PGA]. COVID-19-related outcomes were [1] intensive care unit [ICU] admission, ventilation or death, and [2] hospitalization. Using generalized estimating equations, we determined adjusted odds ratios [aOR, 95% confidence interval] for moderate and severe PGA vs clinical remission/mild PGA, controlling for demographics, medications and COVID-19 diagnosis period. We performed stratified analyses by age [≤50 vs >50 years]. Among 6078 patients, adverse COVID-19 outcomes were more common with active IBD: ICU/ventilation/death in 3.6% [175/4898] of remission/mild, 4.9% [45/920] of moderate and 8.8% [23/260] of severe [p < 0.001]; and hospitalization in 13% [649/4898] of remission/mild, 19% [178/920] of moderate and 38% [100/260] of severe [p < 0.001]. Stratified by decade, effect sizes were larger for younger patients. In patients ≤50 years, severe PGA was independently associated with ICU/ventilation/death (aOR 3.27 [1.15–9.30]) and hospitalization (aOR 4.62 [2.83–7.55]). In contrast, severe PGA was not independently associated with COVID-19 outcomes in those older than 50 years. Clinically active IBD may be a risk factor for severe COVID-19, particularly in younger patients. IBD disease control, including through medication compliance, and strategies to mitigate the risk of COVID-19 infection amongst patients with active IBD [e.g. distancing, immunization] are key to limit adverse COVID-19 outcomes.
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发表时间：
2021-01
期刊：
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影响因子：
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作者：
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DOI：
10.1016/s2468-1253(21)00016-9
发表时间：
2021-04
期刊：
The lancet. Gastroenterology & hepatology
影响因子：
--
作者：
Sebastian S;Walker GJ;Kennedy NA;Conley TE;Patel KV;Subramanian S;Kent AJ;Segal JP;Brookes MJ;Bhala N;Gonzalez HA;Hicks LC;Mehta SJ;Lamb CA;PROTECT-ASUC Study Group
通讯作者：
PROTECT-ASUC Study Group