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Association between 5-aminosalicylates in patients with IBD and risk of severe COVID-19: an artefactual result of research methodology?
  1. Mohamed Attauabi1,2,3,
  2. Jakob Seidelin3,
  3. Johan Burisch1,2
  4. Danish COVID-IBD Study Group
    1. 1 Gastrounit, Medical Division, Copenhagen University Hospital, Hvidovre, Hvidovre, Denmark
    2. 2 Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Copenhagen, Denmark
    3. 3 Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
    1. Correspondence to Dr Mohamed Attauabi, Gastrounit, Medical Division, Hvidovre Hospital, 2650 Hvidovre, Denmark; attauabi12{at}

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    We have read the paper by Ungaro et al with great interest, in which the authors present an assessment of the association between IBD-related medications and the disease course of COVID-19 based on the Surveillance Epidemiology of Coronavirus Under Research Exclusion for IBD (SECURE-IBD) registry.1 Based on data from 1439 patients from this ongoing multinational registry, the authors confirm their previous suggestion that 5-aminosalicylates and/or sulfasalazine (collectively 5-ASA) might be associated with severe outcomes of COVID-19.2 The authors found that 5-ASA was significantly and independently associated with severe COVID-19 in comparison with patients not receiving 5-ASA and patients receiving monotherapy with tumour necrosis factor antagonists. However, no association was found when comparing with patients not receiving any medication and no dose–response relationship of 5-ASA was observed.

    The authors are to be applauded for establishing this innovative registry enabling updated evidence-based decision-making for IBD clinicians. However, as the authors …

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    • Collaborators The Danish COVID-IBD Study Group.

    • Contributors MA—drafting and preparation of this letter. JS and JB—critical review of the letter. All authors reviewed and approved the final manuscript.

    • 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 None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.