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

• Published in: Gut Vol. 69; no. 7; pp. 1213 - 1217
• Main Authors: Bezzio, Cristina, Saibeni, Simone, Variola, Angela, Allocca, Mariangela, Massari, Alessandro, Gerardi, Viviana, Casini, Valentina, Ricci, Chiara, Zingone, Fabiana, Amato, Arnaldo, Caprioli, Flavio, Lenti, Marco Vincenzo, Viganò, Chiara, Ascolani, Marta, Bossa, Fabrizio, Castiglione, Fabiana, Cortelezzi, Claudio, Grossi, Laurino, Milla, Monica, Morganti, Daniela, Pastorelli, Luca, Ribaldone, Davide Giuseppe, Sartini, Alessandro, Soriano, Alessandra, Manes, Gianpiero, Danese, Silvio, Fantini, Massimo, Armuzzi, Alessandro, Daperno, Marco, Fiorino, Gionata
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.07.2020; BMJ Publishing Group
• Series: Original research
• Subjects: Age Factors; Betacoronavirus - isolation & purification; Cardiovascular disease; Chronic obstructive pulmonary disease; Comorbidity; Continuous positive airway pressure; Coronavirus Infections - diagnosis; Coronavirus Infections - mortality; Coronavirus Infections - physiopathology; Coronavirus Infections - therapy; Coronaviruses; COVID-19; Cytomegalovirus; Diagnosis; Female; Hospitalization - statistics & numerical data; Humans; Immunoglobulins; Immunosuppressive agents; Immunosuppressive Agents - therapeutic use; Inflammatory Bowel Disease; Inflammatory Bowel Diseases - epidemiology; Inflammatory Bowel Diseases - therapy; Intubation; Italy - epidemiology; Male; Mechanical ventilation; Middle Aged; Outcome and Process Assessment, Health Care; Pandemics; Patient Acuity; Patient Care Management - methods; Patient Care Management - statistics & numerical data; Pneumonia; Pneumonia, Viral - diagnosis; Pneumonia, Viral - etiology; Pneumonia, Viral - mortality; Pneumonia, Viral - physiopathology; Pneumonia, Viral - therapy; Prospective Studies; Risk Factors; SARS-CoV-2; Viral infections; Italy; epidemiology; IBD
• ISSN: 0017-5749; 1468-3288
• DOI: 10.1136/gutjnl-2020-321411

ObjectivesCOVID-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.DesignThis 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).ResultsBetween 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.ConclusionsActive 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.