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      Risk of COVID 19 in patients with inflammatory bowel diseases compared to a control population

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          Abstract

          Background

          It is unclear whether patients with inflammatory bowel disease (IBD) are at increased risk of COVID-19.

          Objectives

          This observational study compared the prevalence of COVID-19 symptoms, diagnosis and hospitalization in IBD patients with a control population with non-inflammatory bowel disorders.

          Methods

          This multicentre study, included 2733 outpatients (1397 IBD patients and 1336 controls), from eight major gastrointestinal centres in Lombardy, Italy. Patients were invited to complete a web-based questionnaire regarding demographic, historical and clinical features over the previous 6weeks. The prevalence of COVID-19 symptoms, diagnosis and hospitalization for COVID-19 was assessed.

          Results

          1810 patients (64%) responded to the questionnaire (941 IBD patients and 869 controls). IBD patients were significantly younger and of male sex than controls. NSAID use and smoking were more frequent in controls. IBD patients were more likely treated with vitamin-D and vaccinated for influenza. Highly probable COVID-19 on the basis of symptoms and signs was less frequent in the IBD group (3.8% vs 6.3%; OR:0.45, 95%CI:0.28–0.75). IBD patients had a lower rate of nasopharyngeal swab-PCR confirmed diagnosis (0.2% vs 1.2%; OR:0.14, 95%CI:0.03–0.67). There was no difference in hospitalization between the groups (0.1% vs 0.6%; OR:0.14, 95%CI:0.02–1.17).

          Conclusion

          IBD patients do not have an increased risk of COVID-19 specific symptoms or more severe disease compared with a control group of gastroenterology patients.

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          Most cited references35

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)
          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area

            Safiya Richardson, Jamie Hirsch, Mangala Narasimhan … (2020)
            There is limited information describing the presenting characteristics and outcomes of US patients requiring hospitalization for coronavirus disease 2019 (COVID-19).
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              Real-time tracking of self-reported symptoms to predict potential COVID-19

              Cristina Menni, Ana M. Valdes, Maxim Freidin … (2020)
              A total of 2,618,862 participants reported their potential symptoms of COVID-19 on a smartphone-based app. Among the 18,401 who had undergone a SARS-CoV-2 test, the proportion of participants who reported loss of smell and taste was higher in those with a positive test result (4,668 of 7,178 individuals; 65.03%) than in those with a negative test result (2,436 of 11,223 participants; 21.71%) (odds ratio = 6.74; 95% confidence interval = 6.31–7.21). A model combining symptoms to predict probable infection was applied to the data from all app users who reported symptoms (805,753) and predicted that 140,312 (17.42%) participants are likely to have COVID-19.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Dig Liver Dis
                Journal ID (iso-abbrev): Dig Liver Dis
                Title: Digestive and Liver Disease
                Publisher: Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
                ISSN (Print): 1590-8658
                ISSN (Electronic): 1878-3562
                Publication date PMC-release: 26 December 2020
                Publication date (Electronic): 26 December 2020
                Affiliations
                [a ]Gastroenterology Unit – Department of Biomedical and Clinical Sciences FBF - L.Sacco¸ University Hospital, Milan, Italy
                [b ]Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
                [c ]Department of Gastroenterology, Monash Health. Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, Victoria, Australia
                [d ]Gastroenterology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
                [e ]First Department of Internal Medicine, Università degli Studi di Pavia, Pavia, Lombardia, Italy
                [f ]Gastroenterology Unit, Rho Hospital, Rho (MI), ASST Rhodense, Garbagnate Milanese, Italy
                [g ]Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
                [h ]Papa Giovanni XXIII Hospital, Gastroenterology and Digestive Endoscopy Units, Bergamo, Italy
                [i ]Department of Gastroenterology and Endoscopy, Maggiore Hospital, ASST Crema, Crema, Italy
                [j ]Gastroenterology, G. da Saliceto Hospital, Piacenza, Italy
                [k ]I Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, L. Sacco Hospital, Milan, Italy
                [l ]III Division of Infectious Diseases, ASST Fatebenefratelli-Sacco, Department of Biomedical and Clinical Sciences, University of Milan, Italy
                [m ]Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
                [n ]Division of Gastroenterology, ASST Spedali Civili, Brescia, Italy
                Author notes
                [* ]Corresponding author.
                Article
                Publisher Item ID: S1590-8658(20)31093-8
                DOI: 10.1016/j.dld.2020.12.013
                PMC ID: 7762705
                PubMed ID: 33483259
                SO-VID: 403e307a-e2a1-44f9-9400-0cbdcc662736
                Copyright © © 2020 Published by Elsevier Ltd on behalf of Editrice Gastroenterologica Italiana S.r.l.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 5 August 2020
                Date accepted : 15 December 2020
                Categories
                Subject: Alimentary Tract

                Keywords: inflammatory bowel disease,covid-19,symptoms
                Data availability:
                Keywords: inflammatory bowel disease, covid-19, symptoms

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