TY - JOUR
T1 - COVID-19 in Patients with Inflammatory Bowel Disease
T2 - The Israeli Experience
AU - Lichtenstein, Lev
AU - Koslowsky, Benjamin
AU - Ya’acov, Ami Ben
AU - Avni-Biron, Irit
AU - Ovadia, Baruch
AU - Ben-Bassat, Ofer
AU - Naftali, Timna
AU - Kopylov, Uri
AU - Haberman, Yael
AU - Eran, Hagar Banai
AU - Eliakim, Rami
AU - Lahat-Zok, Adi
AU - Hirsch, Ayal
AU - Zittan, Eran
AU - Maharshak, Nitsan
AU - Waterman, Matti
AU - Israeli, Eran
AU - Goren, Idan
AU - Ollech, Jacob E.
AU - Yanai, Henit
AU - Ungar, Bella
AU - Avidan, Benjamin
AU - Hur, Dana Ben
AU - Melamud, Bernardo
AU - Segol, Ori
AU - Shalem, Zippora
AU - Dotan, Iris
AU - Odes, Selwyn H.
AU - Ben-Horin, Shomron
AU - Snir, Yf’At
AU - Milgrom, Yael
AU - Broide, Efrat
AU - Goldin, Eran
AU - Ron, Yulia
AU - Cohen, Nathaniel Aviv
AU - Maoz, Eran
AU - Zborovsky, Maya
AU - Odeh, Safwat
AU - Freha, Naim Abu
AU - Shachar, Eyal
AU - Chowers, Yehuda
AU - Engel, Tal
AU - Reiss-Mintz, Hila
AU - Segal, Arie
AU - Zinger, Adar
AU - Shitrit, Ariella Bar Gil
AU - Delgado, Shmuel
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/3
Y1 - 2022/3
N2 - Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated inflammatory bowel diseases (IBD) affecting millions of people worldwide. IBD therapies, designed for continuous immune suppression, often render patients more susceptible to infections. The effect of the immune suppression on the risk of coronavirus disease-19 (COVID-19) is not fully determined yet. Objective: To describe COVID-19 characteristics and outcomes and to evaluate the association between IBD phenotypes, infection outcomes and immunomodulatory therapies. Methods: In this multi-center study, we prospectively followed IBD patients with proven COVID-19. De-identified data from medical charts were collected including age, gender, IBD type, IBD clinical activity, IBD treatments, comorbidities, symptoms and outcomes of COVID-19. A multivariable regression model was used to examine the effect of immunosuppressant drugs on the risk of infection by COVID-19 and the outcomes. Results: Of 144 IBD patients, 104 (72%) were CD and 40 (28%) were UC. Mean age was 32.2 ± 12.6 years. No mortalities were reported. In total, 94 patients (65.3%) received biologic therapy. Of them, 51 (54%) at escalated doses, 10 (11%) in combination with immunomodulators and 9 (10%) with concomitant corticosteroids. Disease location, behavior and activity did not correlate with the severity of COVID-19. Biologics as monotherapy or with immunomodulators or corticosteroids were not associated with more severe infection. On the contrary, patients receiving biologics had significantly milder infection course (p = 0.001) and were less likely to be hospitalized (p = 0.001). Treatment was postponed in 34.7% of patients until recovery from COVID-19, without consequent exacerbation. Conclusion: We did not witness aggravated COVID-19 outcomes in patients with IBD. Patients treated with biologics had a favorable outcome.
AB - Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated inflammatory bowel diseases (IBD) affecting millions of people worldwide. IBD therapies, designed for continuous immune suppression, often render patients more susceptible to infections. The effect of the immune suppression on the risk of coronavirus disease-19 (COVID-19) is not fully determined yet. Objective: To describe COVID-19 characteristics and outcomes and to evaluate the association between IBD phenotypes, infection outcomes and immunomodulatory therapies. Methods: In this multi-center study, we prospectively followed IBD patients with proven COVID-19. De-identified data from medical charts were collected including age, gender, IBD type, IBD clinical activity, IBD treatments, comorbidities, symptoms and outcomes of COVID-19. A multivariable regression model was used to examine the effect of immunosuppressant drugs on the risk of infection by COVID-19 and the outcomes. Results: Of 144 IBD patients, 104 (72%) were CD and 40 (28%) were UC. Mean age was 32.2 ± 12.6 years. No mortalities were reported. In total, 94 patients (65.3%) received biologic therapy. Of them, 51 (54%) at escalated doses, 10 (11%) in combination with immunomodulators and 9 (10%) with concomitant corticosteroids. Disease location, behavior and activity did not correlate with the severity of COVID-19. Biologics as monotherapy or with immunomodulators or corticosteroids were not associated with more severe infection. On the contrary, patients receiving biologics had significantly milder infection course (p = 0.001) and were less likely to be hospitalized (p = 0.001). Treatment was postponed in 34.7% of patients until recovery from COVID-19, without consequent exacerbation. Conclusion: We did not witness aggravated COVID-19 outcomes in patients with IBD. Patients treated with biologics had a favorable outcome.
KW - Biological drugs
KW - COVID-19
KW - Crohn’s disease
KW - Immune suppression
KW - Inflammatory bowel disease
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85125777986&partnerID=8YFLogxK
U2 - 10.3390/vaccines10030376
DO - 10.3390/vaccines10030376
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 35335008
AN - SCOPUS:85125777986
SN - 2076-393X
VL - 10
JO - Vaccines
JF - Vaccines
IS - 3
M1 - 376
ER -