Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study

Cristina Bezzio; Alessandro Armuzzi; Federica Furfaro; Sandro Ardizzone; Monica Milla; Sonia Carparelli; Ambrogio Orlando; Flavio Andrea Caprioli; Fabiana Castiglione; Chiara Viganò; Davide Giuseppe Ribaldone; Fabiana Zingone; Rita Monterubbianesi; Nicola Imperatore; Stefano Festa; Marco Daperno; Ludovica Scucchi; Antonio Ferronato; Luca Pastorelli; Paola Balestrieri; Chiara Ricci; Maria Cappello; Carla Felice; Gionata Fiorino; Simone Saibeni; Francesca Coppini; Patrizia Alvisi; Viviana Gerardi; Angela Variola; Silvia Mazzuoli; Marco Vincenzo Lenti; Daniela Pugliese; Mariangela Allocca; Marialuisa Allocca; Francesca Ferretti; Ferretto Ferretti; Jenny Roselli; Fabrizio Bossa; Alessandra Giuliano; Alessandro Giuliano; Nicole Piazza; Gianpiero Manes; Alessandro Sartini; Andrea Buda; Alessandro Buda; Federica Micheli; Valeria Ciardo; Giovanni Casella; Angelo Viscido; Aniello Viscido; Giorgia Bodini; Valentina Casini; Alessandra Soriano; Arnaldo Amato; Laurino Grossi; Luigi Grossi; Sara Onali; Sebastiano Onali; Matteo Rottoli; Rocco Spagnuolo; Stefania Baroni; Silvia Baroni; Claudio Camillo Cortelezzi; Monia Baldoni; Michele Baldoni; Marta Vernero; Franco Scaldaferri; Giovanni Maconi; Alessia Dalila Guarino; Andrea Palermo; Ofelia Anna Palermo; Renata D'Incà; Maria Lia Scribano; Livia Biancone; Lucio Carrozza; Marta Ascolani; Francesco Costa; Antonio Di Sabatino; Irene Zammarchi; Matteo Gottin; Francesco Simone Conforti

doi:10.1111/apt.16663

Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study

Cristina Bezzio, Alessandro Armuzzi, Federica Furfaro, Sandro Ardizzone, Monica Milla, Sonia Carparelli, Ambrogio Orlando, Flavio Andrea Caprioli, Fabiana Castiglione, Chiara Viganò, Davide Giuseppe Ribaldone, Fabiana Zingone, Rita Monterubbianesi, Nicola Imperatore, Stefano Festa, Marco Daperno, Ludovica Scucchi, Antonio Ferronato, Luca Pastorelli, Paola BalestrieriChiara Ricci, Maria Cappello, Carla Felice, Gionata Fiorino, Simone Saibeni, Francesca Coppini, Patrizia Alvisi, Viviana Gerardi, Angela Variola, Silvia Mazzuoli, Marco Vincenzo Lenti, Daniela Pugliese, Mariangela Allocca, Marialuisa Allocca, Francesca Ferretti, Ferretto Ferretti, Jenny Roselli, Fabrizio Bossa, Alessandra Giuliano, Alessandro Giuliano, Nicole Piazza, Gianpiero Manes, Alessandro Sartini, Andrea Buda, Alessandro Buda, Federica Micheli, Valeria Ciardo, Giovanni Casella, Angelo Viscido, Aniello Viscido, Giorgia Bodini, Valentina Casini, Alessandra Soriano, Arnaldo Amato, Laurino Grossi, Luigi Grossi, Sara Onali, Sebastiano Onali, Matteo Rottoli, Rocco Spagnuolo, Stefania Baroni, Silvia Baroni, Claudio Camillo Cortelezzi, Monia Baldoni, Michele Baldoni, Marta Vernero, Franco Scaldaferri, Giovanni Maconi, Alessia Dalila Guarino, Andrea Palermo, Ofelia Anna Palermo, Renata D'Incà, Maria Lia Scribano, Livia Biancone, Lucio Carrozza, Marta Ascolani, Francesco Costa, Antonio Di Sabatino, Irene Zammarchi, Matteo Gottin, Francesco Simone Conforti

Research output: Contribution to journal › Article

Abstract

Background: Older age and comorbidities are the main risk factors for adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims: To assess risk factors for adverse outcomes of COVID-19 in IBD patients and use the identified risk factors to build risk indices. Methods: Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results: Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS-CoV-2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID-19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune-mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID-19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID-19 outcomes, but anti-TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID-19 in CD. Conclusion: The course of COVID-19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID-19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID-19 re-vaccination or for therapies for SARS-CoV-2 infection.

Original language	English
Pages (from-to)	1432-1441
Number of pages	10
Journal	ALIMENTARY PHARMACOLOGY & THERAPEUTICS
Volume	54
DOIs	https://doi.org/10.1111/apt.16663
Publication status	Published - 2021

Keywords

INFLAMMATORY BOWEL DISEASE
SARS-CoV-2

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/apt.16663

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Bezzio, C., Armuzzi, A., Furfaro, F., Ardizzone, S., Milla, M., Carparelli, S., Orlando, A., Caprioli, F. A., Castiglione, F., Viganò, C., Ribaldone, D. G., Zingone, F., Monterubbianesi, R., Imperatore, N., Festa, S., Daperno, M., Scucchi, L., Ferronato, A., Pastorelli, L., ... Conforti, F. S. (2021). Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study. ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 54, 1432-1441. https://doi.org/10.1111/apt.16663

@article{7a19bb5fbf0a4f8fa1b48bcb52821e55,

title = "Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study",

abstract = "Background: Older age and comorbidities are the main risk factors for adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims: To assess risk factors for adverse outcomes of COVID-19 in IBD patients and use the identified risk factors to build risk indices. Methods: Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results: Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS-CoV-2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID-19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune-mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID-19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID-19 outcomes, but anti-TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID-19 in CD. Conclusion: The course of COVID-19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID-19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID-19 re-vaccination or for therapies for SARS-CoV-2 infection.",

keywords = "INFLAMMATORY BOWEL DISEASE, SARS-CoV-2, INFLAMMATORY BOWEL DISEASE, SARS-CoV-2",

author = "Cristina Bezzio and Alessandro Armuzzi and Federica Furfaro and Sandro Ardizzone and Monica Milla and Sonia Carparelli and Ambrogio Orlando and Caprioli, {Flavio Andrea} and Fabiana Castiglione and Chiara Vigan{\`o} and Ribaldone, {Davide Giuseppe} and Fabiana Zingone and Rita Monterubbianesi and Nicola Imperatore and Stefano Festa and Marco Daperno and Ludovica Scucchi and Antonio Ferronato and Luca Pastorelli and Paola Balestrieri and Chiara Ricci and Maria Cappello and Carla Felice and Gionata Fiorino and Simone Saibeni and Francesca Coppini and Patrizia Alvisi and Viviana Gerardi and Angela Variola and Silvia Mazzuoli and Lenti, {Marco Vincenzo} and Daniela Pugliese and Mariangela Allocca and Marialuisa Allocca and Francesca Ferretti and Ferretto Ferretti and Jenny Roselli and Fabrizio Bossa and Alessandra Giuliano and Alessandro Giuliano and Nicole Piazza and Gianpiero Manes and Alessandro Sartini and Andrea Buda and Alessandro Buda and Federica Micheli and Valeria Ciardo and Giovanni Casella and Angelo Viscido and Aniello Viscido and Giorgia Bodini and Valentina Casini and Alessandra Soriano and Arnaldo Amato and Laurino Grossi and Luigi Grossi and Sara Onali and Sebastiano Onali and Matteo Rottoli and Rocco Spagnuolo and Stefania Baroni and Silvia Baroni and Cortelezzi, {Claudio Camillo} and Monia Baldoni and Michele Baldoni and Marta Vernero and Franco Scaldaferri and Giovanni Maconi and Guarino, {Alessia Dalila} and Andrea Palermo and Palermo, {Ofelia Anna} and Renata D'Inc{\`a} and Scribano, {Maria Lia} and Livia Biancone and Lucio Carrozza and Marta Ascolani and Francesco Costa and {Di Sabatino}, Antonio and Irene Zammarchi and Matteo Gottin and Conforti, {Francesco Simone}",

year = "2021",

doi = "10.1111/apt.16663",

language = "English",

volume = "54",

pages = "1432--1441",

journal = "ALIMENTARY PHARMACOLOGY & THERAPEUTICS",

issn = "0269-2813",

publisher = "Blackwell Science Limited:PO Box 88, Oxford OX2 0NE United Kingdom:011 44 1865 776868, 011 44 1865 206038, EMAIL: [email protected], INTERNET: http://www.blackwell-science.com, Fax: 011 44 1865 721205",

}

Bezzio, C, Armuzzi, A, Furfaro, F, Ardizzone, S, Milla, M, Carparelli, S, Orlando, A, Caprioli, FA, Castiglione, F, Viganò, C, Ribaldone, DG, Zingone, F, Monterubbianesi, R, Imperatore, N, Festa, S, Daperno, M, Scucchi, L, Ferronato, A, Pastorelli, L, Balestrieri, P, Ricci, C, Cappello, M, Felice, C, Fiorino, G, Saibeni, S, Coppini, F, Alvisi, P, Gerardi, V, Variola, A, Mazzuoli, S, Lenti, MV, Pugliese, D, Allocca, M, Allocca, M, Ferretti, F, Ferretti, F, Roselli, J, Bossa, F, Giuliano, A, Giuliano, A, Piazza, N, Manes, G, Sartini, A, Buda, A, Buda, A, Micheli, F, Ciardo, V, Casella, G, Viscido, A, Viscido, A, Bodini, G, Casini, V, Soriano, A, Amato, A, Grossi, L, Grossi, L, Onali, S, Onali, S, Rottoli, M, Spagnuolo, R, Baroni, S, Baroni, S, Cortelezzi, CC, Baldoni, M, Baldoni, M, Vernero, M, Scaldaferri, F, Maconi, G, Guarino, AD, Palermo, A, Palermo, OA, D'Incà, R, Scribano, ML, Biancone, L, Carrozza, L, Ascolani, M, Costa, F, Di Sabatino, A, Zammarchi, I, Gottin, M & Conforti, FS 2021, 'Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study', ALIMENTARY PHARMACOLOGY & THERAPEUTICS, vol. 54, pp. 1432-1441. https://doi.org/10.1111/apt.16663

TY - JOUR

T1 - Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study

AU - Bezzio, Cristina

AU - Armuzzi, Alessandro

AU - Furfaro, Federica

AU - Ardizzone, Sandro

AU - Milla, Monica

AU - Carparelli, Sonia

AU - Orlando, Ambrogio

AU - Caprioli, Flavio Andrea

AU - Castiglione, Fabiana

AU - Viganò, Chiara

AU - Ribaldone, Davide Giuseppe

AU - Zingone, Fabiana

AU - Monterubbianesi, Rita

AU - Imperatore, Nicola

AU - Festa, Stefano

AU - Daperno, Marco

AU - Scucchi, Ludovica

AU - Ferronato, Antonio

AU - Pastorelli, Luca

AU - Balestrieri, Paola

AU - Ricci, Chiara

AU - Cappello, Maria

AU - Felice, Carla

AU - Fiorino, Gionata

AU - Saibeni, Simone

AU - Coppini, Francesca

AU - Alvisi, Patrizia

AU - Gerardi, Viviana

AU - Variola, Angela

AU - Mazzuoli, Silvia

AU - Lenti, Marco Vincenzo

AU - Pugliese, Daniela

AU - Allocca, Mariangela

AU - Allocca, Marialuisa

AU - Ferretti, Francesca

AU - Ferretti, Ferretto

AU - Roselli, Jenny

AU - Bossa, Fabrizio

AU - Giuliano, Alessandra

AU - Giuliano, Alessandro

AU - Piazza, Nicole

AU - Manes, Gianpiero

AU - Sartini, Alessandro

AU - Buda, Andrea

AU - Buda, Alessandro

AU - Micheli, Federica

AU - Ciardo, Valeria

AU - Casella, Giovanni

AU - Viscido, Angelo

AU - Viscido, Aniello

AU - Bodini, Giorgia

AU - Casini, Valentina

AU - Soriano, Alessandra

AU - Amato, Arnaldo

AU - Grossi, Laurino

AU - Grossi, Luigi

AU - Onali, Sara

AU - Onali, Sebastiano

AU - Rottoli, Matteo

AU - Spagnuolo, Rocco

AU - Baroni, Stefania

AU - Baroni, Silvia

AU - Cortelezzi, Claudio Camillo

AU - Baldoni, Monia

AU - Baldoni, Michele

AU - Vernero, Marta

AU - Scaldaferri, Franco

AU - Maconi, Giovanni

AU - Guarino, Alessia Dalila

AU - Palermo, Andrea

AU - Palermo, Ofelia Anna

AU - D'Incà, Renata

AU - Scribano, Maria Lia

AU - Biancone, Livia

AU - Carrozza, Lucio

AU - Ascolani, Marta

AU - Costa, Francesco

AU - Di Sabatino, Antonio

AU - Zammarchi, Irene

AU - Gottin, Matteo

AU - Conforti, Francesco Simone

PY - 2021

Y1 - 2021

N2 - Background: Older age and comorbidities are the main risk factors for adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims: To assess risk factors for adverse outcomes of COVID-19 in IBD patients and use the identified risk factors to build risk indices. Methods: Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results: Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS-CoV-2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID-19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune-mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID-19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID-19 outcomes, but anti-TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID-19 in CD. Conclusion: The course of COVID-19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID-19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID-19 re-vaccination or for therapies for SARS-CoV-2 infection.

AB - Background: Older age and comorbidities are the main risk factors for adverse COVID-19 outcomes in patients with inflammatory bowel disease (IBD). The impact of IBD medications is still under investigation. Aims: To assess risk factors for adverse outcomes of COVID-19 in IBD patients and use the identified risk factors to build risk indices. Methods: Observational cohort study. Univariable and multivariable logistic regression was used to identify risk factors associated with pneumonia, hospitalisation, need for ventilatory support, and death. Results: Of the 937 patients (446 with ulcerative colitis [UC]) evaluated, 128 (13.7%) had asymptomatic SARS-CoV-2 infection, 664 (70.8%) had a favourable course, and 135 (15.5%) had moderate or severe COVID-19. In UC patients, obesity, active disease and comorbidities were significantly associated with adverse outcomes. In patients with Crohn's disease (CD), age, obesity, comorbidities and an additional immune-mediated inflammatory disease were identified as risk factors. These risk factors were incorporated into two indices to identify patients with UC or CD with a higher risk of adverse COVID-19 outcomes. In multivariable analyses, no single IBD medication was associated with poor COVID-19 outcomes, but anti-TNF agents were associated with a lower risk of pneumonia in UC, and lower risks of hospitalisation and severe COVID-19 in CD. Conclusion: The course of COVID-19 in patients with IBD is similar to that in the general population. IBD patients with active disease and comorbidities are at greater risk of adverse COVID-19 outcomes. IBD medications do not pose additional risks. The risk indices may help to identify patients who should be prioritised for COVID-19 re-vaccination or for therapies for SARS-CoV-2 infection.

KW - INFLAMMATORY BOWEL DISEASE

KW - SARS-CoV-2

KW - INFLAMMATORY BOWEL DISEASE

KW - SARS-CoV-2

UR - http://hdl.handle.net/10807/204123

U2 - 10.1111/apt.16663

DO - 10.1111/apt.16663

M3 - Article

SN - 0269-2813

VL - 54

SP - 1432

EP - 1441

JO - ALIMENTARY PHARMACOLOGY & THERAPEUTICS

JF - ALIMENTARY PHARMACOLOGY & THERAPEUTICS

ER -

Therapies for inflammatory bowel disease do not pose additional risks for adverse outcomes of SARS-CoV-2 infection: an IG-IBD study

Abstract

Keywords

UN SDGs

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