Outcomes of COVID-19 in Patients with Inflammatory Bowel Disease: Comparison with Household Members and the Role of IBD Medications

• Published in: Archives of Iranian medicine 2022-01, Vol.25 (1), p.17-25
• Main Authors: Sima, Ali Reza, Saberzadeh-Ardestani, Bahar, Vahedi, Homayoon, Fakheri, Hafez, Mansour-Ghanaei, Fariborz, Maleki, Iradj, Nasseri-Moghaddam, Siavosh, Vosoghinia, Hasan, Ghadir, Mohammad Reza, Hormati, Ahmad, Kasaeian, Amir, Radmard, Amir Reza, Khosravi, Bardia, Malekzadeh, Masoud, Alatab, Sudabeh, Sadeghi, Anahita, Aminisani, Nayyereh, Poustchi, Hossein, Gonoudi, Elnaz, Anushiravani, Amir, Rayatpisheh, Maryam, Colombel, Jean-Frederic, Ungaro, Ryan C., Malekzadeh, Reza
• Format: Article
• Language: English
• Subjects: Coronaviruses; COVID-19; Hospitalization; Households; Inflammatory bowel disease; Tumor necrosis factor-TNF
• ISSN: 1029-2977; 1735-3947
• DOI: 10.34172/aim.2022.04

Background: Most data on the effect of inflammatory bowel disease (IBD) and its treatments on coronavirus disease 2019 (COVID-19) outcomes have not had non-IBD comparators. Hence, we aimed to describe COVID-19 outcomes in IBD compared to non-IBD patients. Methods: We conducted a prospective cohort study of registered IBD patients with confirmed COVID-19 from six provinces in Iran from February to April 2020. Proven COVID-19 patients were followed up at four weeks and the frequency of outcomes was assessed. Multivariable logistic regression was used to assess associations between demographics, clinical characteristics and COVID-19 outcomes. Results: Overall, 2159 IBD patients and 4721 household members were enrolled, with 84 (3.9%) and 49 (1.1%) participants having confirmed COVID-19, respectively. Household spread of COVID-19 was not common in this cohort (1.2%). While hospitalization was significantly more frequent in IBD patients compared with non-IBD household members (27.1% vs. 6.0%, P=0.002), there was no significant difference in the frequency of severe cases. Age and presence of IBD were positively associated with hospitalization in IBD compared with non-IBD household members (OR: 1.06, 95% CI: 1.03-1.10; OR: 5.7, 95% CI: 2.02– 16.07, respectively). Age, presence of new gastrointestinal symptoms, and 5-aminosalicylic acid (5-ASA) use were associated with higher hospitalization rate in IBD patients (OR: 1.13, 95% CI: 1.05–1.23; OR: 6.49, 95% CI: 1.87–22.54; OR: 6.22, 95% CI: 1.90–20.36, respectively). Anti-tumor necrosis factor (TNF) was not associated with more severe outcomes. Conclusion: Age, presence of new gastrointestinal symptoms and use of 5-ASA were associated with increased hospitalization rate among IBD patients, while anti-TNF therapy had no statistical association.