Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study

Gut. 2020 Jul;69(7):1213-1217. doi: 10.1136/gutjnl-2020-321411. Epub 2020 Apr 30.

Abstract

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.

Keywords: IBD; epidemiology.

Publication types

  • Observational Study

MeSH terms

  • Age Factors
  • Betacoronavirus / isolation & purification*
  • COVID-19
  • Comorbidity
  • Coronavirus Infections* / diagnosis
  • Coronavirus Infections* / mortality
  • Coronavirus Infections* / physiopathology
  • Coronavirus Infections* / therapy
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Inflammatory Bowel Diseases* / epidemiology
  • Inflammatory Bowel Diseases* / therapy
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Pandemics*
  • Patient Acuity
  • Patient Care Management* / methods
  • Patient Care Management* / statistics & numerical data
  • Pneumonia, Viral* / diagnosis
  • Pneumonia, Viral* / etiology
  • Pneumonia, Viral* / mortality
  • Pneumonia, Viral* / physiopathology
  • Pneumonia, Viral* / therapy
  • Prospective Studies
  • Risk Factors
  • SARS-CoV-2

Substances

  • Immunosuppressive Agents