Patients with Inflammatory Bowel Disease Are Not at Increased Risk of COVID-19: A Large Multinational Cohort Study.
Patients with Inflammatory Bowel Disease Are Not at Increased Risk of COVID-19: A Large Multinational Cohort Study.
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DOI：
10.3390/jcm9113533
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发表时间：
2020-10-31
影响因子：
3.9
通讯作者：
Fiorino G
中科院分区：
文献类型：
--
作者：
Allocca M;Chaparro M;Gonzalez HA;Bosca-Watts MM;Palmela C;D'Amico F;Zacharopoulou E;Kopylov U;Ellul P;Bamias G;Ntelis V;Lahat A;Mantzaris GJ;Papaconstantinou I;Katsanos K;Uspenskaya Y;Christodoulou D;Ben Horin S;Peyrin-Biroulet L;Torres J;Sebastian S;Gisbert JP;Danese S;Fiorino G
COVID-19对药物免疫抑制下的炎症性肠病（IBD）患者的影响仍不清楚。我们在2020年2月21日至6月30日的一个大型IBD队列中研究了COVID-19的发病率以及免疫抑制和遏制措施对SARS-CoV-2感染风险的影响。在总计23，879例IBD患者中，97例IBD患者（43例UC，53例CD，1例未分类IBD）和合并COVID-19入组了研究。IBD患者与普通人群中SARS-CoV-2感染的累积发生率分别为0.406%和0.402%病例。23名患者（24%）住院，21名（22%）患有肺炎，4名（4%）入住重症监护室，1名患者死亡。我们队列的致死率为1%，而一般人群为9%。在多变量分析中，年龄> 65岁与肺炎和住院风险增加相关（OR 11.6，95% CI 2.18-62.60; OR 5.1，95%CI 1.10-23.86），皮质类固醇治疗增加住院风险（OR 7.6，95% CI 1.48-40.05），而单克隆抗体与肺炎和住院风险降低相关（OR 0.1，95% CI 0.04-0.52; OR 0.3，95% CI 0.10-0.90）。IBD患者的COVID-19风险与一般人群相似。全国封锁有效预防了我们队列的感染。高龄和皮质类固醇治疗对COVID-19的结果产生负面影响，而单克隆抗体似乎没有不利影响。
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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