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

Franco Scaldaferri, Alessandro Armuzzi, Antonio Orlando, Carla Felice, Daniela Pugliese, Marialuisa Allocca, Ferretto Ferretti, Alessandro Giuliano, Alessandro Buda, Giovanni Casella, Sebastiano Onali, Rocco Spagnuolo, Michele Baldoni, Cristina Bezzio, Federica Furfaro, Sandro Ardizzone, Monica Milla, Sonia Carparelli, Ambrogio Orlando, Flavio Andrea CaprioliFabiana 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, Gionata Fiorino, Simone Saibeni, Francesca Coppini, Patrizia Alvisi, Viviana Gerardi, Angela Variola, Silvia Mazzuoli, Marco Vincenzo Lenti, Mariangela Allocca, Francesca Ferretti, Jenny Roselli, Fabrizio Bossa, Alessandra Giuliano, Nicole Piazza, Gianpiero Manes, Alessandro Sartini, Andrea Buda, Federica Micheli, Valeria Ciardo, Angelo Viscido, Giorgia Bodini, Valentina Casini, Alessandra Soriano, Arnaldo Amato, Laurino Grossi, Sara Onali, Matteo Rottoli, Stefania Baroni, Claudio Camillo Cortelezzi, Monia Baldoni, Marta Vernero, Giovanni Maconi, Alessia Dalila Guarino, Andrea 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

Risultato della ricerca: Contributo in rivistaArticolo in rivista

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.
Lingua originaleEnglish
pagine (da-a)1432-1441
Numero di pagine10
RivistaALIMENTARY PHARMACOLOGY & THERAPEUTICS
Volume54
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • SARS-CoV-2
  • INFLAMMATORY BOWEL DISEASE

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