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Impact of COVID-19 Treatment on Real-World Outcomes in Inflammatory Bowel Disease

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Abstract

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.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Section of Digestive Diseases, Yale School of Medicine, 333 Cedar St, New Haven, CT, 06520, USA

    Laura C. Sahyoun, Jonathan Fetene, Chandler McMillan, Petr Protiva, Badr Al Bawardy, Jill K. J. Gaidos & Deborah Proctor

  2. Division of Gastroenterology and Hepatology, Weill Cornell Medicine, 525 East 68th Street, New York, NY, 10065, USA

    Laura C. Sahyoun

  3. VA Connecticut Health Care System, 950 Campbell Avenue, West Haven, CT, 06516, USA

    Petr Protiva

  4. Division of Gastroenterology and Hepatology, Department of Internal Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Badr Al Bawardy

Authors
  1. Laura C. Sahyoun
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  2. Jonathan Fetene
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  3. Chandler McMillan
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  4. Petr Protiva
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  7. Deborah Proctor
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Corresponding author

Correspondence to Laura C. Sahyoun.

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Conflict of interest

Dr. Badr Al-Bawardy: Speaker fees: AbbVie, Takeda, Bristol-Myers Squibb, Janssen Pharmaceuticals. Advisory board: Bristol-Myers Squibb, Pfizer. Dr. Jill KJ Gaidos: Advisor board: Pfizer, Janssen. Research support: Bristol-Myers Squibb.

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Sahyoun, L.C., Fetene, J., McMillan, C. et al. Impact of COVID-19 Treatment on Real-World Outcomes in Inflammatory Bowel Disease. Dig Dis Sci (2024). https://doi.org/10.1007/s10620-024-08355-3

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  • DOI: https://doi.org/10.1007/s10620-024-08355-3

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