Objectives COVID-19 has rapidly become a major health emergency worldwide. Patients with IBD are at increased risk of infection, especially when they have active disease and are taking immunosuppressive therapy. The characteristics and outcomes of COVID-19 in patients with IBD remain unclear.
Design This Italian prospective observational cohort study enrolled consecutive patients with an established IBD diagnosis and confirmed COVID-19. Data regarding age, sex, IBD (type, treatments and clinical activity), other comorbidities (Charlson Comorbidity Index (CCI)), signs and symptoms of COVID-19 and therapies were compared with COVID-19 outcomes (pneumonia, hospitalisation, respiratory therapy and death).
Results Between 11 and 29 March 2020, 79 patients with IBD with COVID-19 were enrolled at 24 IBD referral units. Thirty-six patients had COVID-19-related pneumonia (46%), 22 (28%) were hospitalised, 7 (9%) required non-mechanical ventilation, 9 (11%) required continuous positive airway pressure therapy, 2 (3%) had endotracheal intubation and 6 (8%) died. Four patients (6%) were diagnosed with COVID-19 while they were being hospitalised for a severe flare of IBD. Age over 65 years (p=0.03), UC diagnosis (p=0.03), IBD activity (p=0.003) and a CCI score >1 (p=0.04) were significantly associated with COVID-19 pneumonia, whereas concomitant IBD treatments were not. Age over 65 years (p=0.002), active IBD (p=0.02) and higher CCI score were significantly associated with COVID-19-related death.
Conclusions Active IBD, old age and comorbidities were associated with a negative COVID-19 outcome, whereas IBD treatments were not. Preventing acute IBD flares may avoid fatal COVID-19 in patients with IBD. Further research is needed.
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Correction notice This article has been corrected since it published Online First. Affiliation 3 has been updated.
Contributors CB, SS planning the study, drafting the article, analysis and interpretation of data. GF drafting article, analysis and interpretation of data. All other authors: data collections, critical revision of article for important intellectual content. All authors approved the final version of the manuscript including authorship list.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests CB received lecture fees from Takeda, AbbVie and Janssen. SS received lecture fees from Takeda Pharmaceuticals and Janssen Pharmaceuticals and served as a consultant and a member of Advisory Boards for AbbVie and Janssen Pharmaceuticals. AV received lecture fees from Takeda and AbbVie and served as consultant for MSD, Pfizer and Janssen. MA received consulting fees from Nikkiso Europe and lecture fees from Janssen, Abbvie and Pfizer. CR reports personal fee from Abbvie, Janssen Cilag, MSD, Recordati, Takeda and Vifor. FC served as consultant and a member of advisory board for Mundipharma, AbbVie, MS&D, Takeda, Janssen, Roche, Celgene and received lecture fees from AbbVie, Amgen, Ferring, Takeda, Allergy Therapeutics and unrestricted research grants from Giuliani, Sofar, MSD, Takeda, AbbVie. FB served as a member of advisory board for Biogen and Janssen, Takeda, Celgene, Mundipharma, AbbVie and MSD. FC served as consultant and a member of advisory board for Mundipharma, AbbVie, MS&D, Takeda, Janssen, Roche, Celgene and received lecture fees from AbbVie, Amgen, Ferring, Takeda, Allergy Therapeutics. DGR served as consultant and received lecture fees from Janssen, Ferring, Errekappa. SD served as a speaker, consultant and advisory board member for Schering-Plough, Abbott (AbbVie) Laboratories, Merck, UCB Pharma, Ferring, Cellerix, Millenium Takeda, Nycomed, Pharmacosmos, Actelion, Alfa Wasserman, Genentech, Grunenthal, Pfizer, AstraZeneca, Novo Nordisk, Cosmo Pharmaceuticals, Vifor and Johnson and Johnson. MCF received fees as member of advisory boards and participation to sponsored symposia from AbbVie, Takeda, Jannsen-Cilag, Pfizer, Sandoz. AA served as a consultant for AbbVie, Allergan, Amgen, Biogen, Bristol Myers Squibb, Celgene, Celltrion, Ferring, Gilead, Janssen, Lilly, MSD, Mylan, Pfizer, Roche, Samsung Bioepis, Sandoz and Takeda; MD served as a speaker, consultant and advisory board member for AbbVie, Takeda, Janssen, Norgine, Pfizer, MSD, Celltrion, Roche, Gilead, Bioclinica, Ferring, SOFAR, Chiesi, Zambon. GF received consultancy fees from Ferring, MSD, AbbVie, Takeda, Janssen, Amgen, Sandoz, Samsung Bioepis, Celltrion.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval The study protocol was approved by the IG-IBD Scientific Committee and by the Coordinating Ethical Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.