Background

While there are multiple safe and effective agents for COVID-19 treatment, their impact in inflammatory bowel disease (IBD) remains uncertain.

Aims

Our objective was to assess the effects of these therapies on both IBD and COVID outcomes.

Methods

A single-center retrospective study of adult patients with IBD who contracted COVID-19 between 12/2020 and 11/2022 was performed. Patients were stratified by COVID-19 treatment (antivirals and/or intravenous antibodies) vs no therapy. The primary outcome was the development of severe COVID-19 infection, defined by need for supplemental oxygen, corticosteroids and/or antibiotics, or hospitalization. Secondary outcomes included rates of withholding advanced IBD therapy (defined as biologic agents or small molecules) and of post-COVID-19 IBD flare.

Results

Of 127 patients with COVID-19 infection, 70% were on advanced therapies, 35% received COVID-19 treatment, and 15% developed severe COVID-19. Those treated for COVID-19 were more likely to be on corticosteroids [odds ratio (OR) 4.61, 95% confidence interval (CI) 1.72–12.39, p = 0.002] or advanced IBD therapies (OR 2.78, 95% CI 1.04–7.43, p = 0.041). After adjusting for age, race, sex, corticosteroid use, obesity, COVID-19 vaccination status, and severe COVID-19 infection, those treated for COVID-19 were more likely to have IBD therapy held (OR 6.95, 95% CI 1.72–28.15, p = 0.007). There was no significant difference in rates of post-COVID-19 IBD flares or severe COVID-19 infection. There were no COVID-related deaths.

Conclusions

Patients with IBD on advanced therapies were frequently treated for acute COVID-19. Although COVID-19 treatment was associated with temporary withholding of IBD therapy, it did not result in increased IBD flares.

中文翻译：

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COVID-19 治疗对炎症性肠病实际结果的影响

背景

尽管有多种安全有效的药物可用于治疗 COVID-19，但它们对炎症性肠病 (IBD) 的影响仍不确定。

目标

我们的目标是评估这些疗法对 IBD 和 COVID 结局的影响。

方法

对 2020 年 12 月至 2022 年 11 月期间感染 COVID-19 的成年 IBD 患者进行了一项单中心回顾性研究。患者按接受过 COVID-19 治疗（抗病毒药物和/或静脉注射抗体）与未接受治疗进行分层。主要结局是出现严重的 COVID-19 感染，定义为需要补充氧气、皮质类固醇和/或抗生素，或住院治疗。次要结局包括拒绝先进 IBD 治疗（定义为生物制剂或小分子）的比率和 COVID-19 后 IBD 发作的比率。

结果

在 127 名感染了 COVID-19 的患者中，70% 接受了高级治疗，35% 接受了 COVID-19 治疗，15% 发展为重症 COVID-19。接受 COVID-19 治疗的患者更有可能接受皮质类固醇治疗 [比值比 (OR) 4.61，95% 置信区间 (CI) 1.72–12.39，p  = 0.002] 或先进 IBD 治疗（OR 2.78，95% CI 1.04–7.43） ，p  = 0.041）。在调整年龄、种族、性别、皮质类固醇使用、肥胖、COVID-19 疫苗接种状况和严重 COVID-19 感染后，接受 COVID-19 治疗的患者更有可能接受 IBD 治疗（OR 6.95，95% CI 1.72– 28.15，p  = 0.007）。COVID-19 后 IBD 发作或严重 COVID-19 感染的发生率没有显着差异。没有与新冠病毒相关的死亡。

结论

接受先进疗法的 IBD 患者经常接受急性 COVID-19 治疗。尽管 COVID-19 治疗与暂时停止 IBD 治疗有关，但它并没有导致 IBD 发作增加。