Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study
Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study
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DOI：
10.1136/gutjnl-2020-321411
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发表时间：
2020-07-01
期刊：
影响因子：
24.5
通讯作者：
Fiorino, Gionata
中科院分区：
文献类型：
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作者：
Bezzio, Cristina;Saibeni, Simone;Fiorino, Gionata
目的新冠肺炎已迅速成为全球范围内的重大突发公共卫生事件。IBD患者感染的风险增加，特别是当他们患有活动性疾病并正在接受免疫抑制治疗时。新冠肺炎在炎症性肠病患者中的特征和结果尚不清楚。设计：这项意大利前瞻性观察队列研究纳入了连续入选的确诊为炎症性肠病并确认为新冠肺炎的患者。将年龄、性别、肠源性疾病(类型、治疗和临床活动)、其他合并症(Charlson共病指数)、新冠肺炎的体征和症状以及治疗方法与新冠肺炎的预后(肺炎、住院、呼吸治疗和死亡)进行比较。结果2020年3月11日至29日，79例IBD合并新冠肺炎的患者在24个IBD转诊单元登记。新冠肺炎相关性肺炎36例(46%)，住院22例(28%)，非机械通气7例(9%)，持续气道正压治疗9例(11%)，气管插管2例(3%)，死亡6例(8%)。4名患者(6%)在因严重的炎症性肠病住院期间被诊断为新冠肺炎患者。年龄大于65岁(p=0.03)、诊断为UC(p=0.03)、IBD活动(p=0.003)和CCI评分(p=0.04)与新冠肺炎肺炎显著相关，而合并IBD治疗则不显著。年龄大于65岁(p=0.002)、活动期肠源性肠病(p=0.02)和较高的CCI评分与新冠肺炎相关死亡显著相关。结论活动性肠源性肠病、高龄和合并疾病与新冠肺炎预后不良相关，而肠源性肠病的治疗与预后无关。预防IBD急性发作可以避免IBD患者发生致命的新冠肺炎。还需要进一步的研究。
Objectives COVID-19 has rapidly become a major health emergency worldwide. Patients with IBD are at increased risk of infection, especially when they have active disease and are taking immunosuppressive therapy. The characteristics and outcomes of COVID-19 in patients with IBD remain unclear.Design This Italian prospective observational cohort study enrolled consecutive patients with an established IBD diagnosis and confirmed COVID-19. Data regarding age, sex, IBD (type, treatments and clinical activity), other comorbidities (Charlson Comorbidity Index (CCI)), signs and symptoms of COVID-19 and therapies were compared with COVID-19 outcomes (pneumonia, hospitalisation, respiratory therapy and death).Results Between 11 and 29 March 2020, 79 patients with IBD with COVID-19 were enrolled at 24 IBD referral units. Thirty-six patients had COVID-19-related pneumonia (46%), 22 (28%) were hospitalised, 7 (9%) required non-mechanical ventilation, 9 (11%) required continuous positive airway pressure therapy, 2 (3%) had endotracheal intubation and 6 (8%) died. Four patients (6%) were diagnosed with COVID-19 while they were being hospitalised for a severe flare of IBD. Age over 65 years (p=0.03), UC diagnosis (p=0.03), IBD activity (p=0.003) and a CCI score >1 (p=0.04) were significantly associated with COVID-19 pneumonia, whereas concomitant IBD treatments were not. Age over 65 years (p=0.002), active IBD (p=0.02) and higher CCI score were significantly associated with COVID-19-related death.Conclusions Active IBD, old age and comorbidities were associated with a negative COVID-19 outcome, whereas IBD treatments were not. Preventing acute IBD flares may avoid fatal COVID-19 in patients with IBD. Further research is needed.