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      P637 Incidence rate and clinical outcome of severe COVID-19 in Inflammatory Bowel Disease patients in a population-based setting

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          Abstract

          Background

          The broad use of immunosuppressants and biologicals in Inflammatory Bowel Disease (IBD) patients increases the susceptibility to severe infections, and possibly COVID-19. Recently, in a Swedish population-based study it was suggested that IBD patients are at an increased risk of hospitalization for COVID-19, although course of COVID-19 did not differ from controls. Data on the outcome of COVID-19 in IBD patients from heavily affected regions remain, however, limited. South-Limburg has the second highest COVID-19 mortality rate in the Netherlands. We aimed to determine the incidence rate and outcome of severe COVID-19 in IBD patients in a population-based setting in South-Limburg.

          Methods

          We identified all IBD patients who presented at the emergency department (ED) of the only two hospitals covering the whole South-Limburg region with COVID-19 associated symptoms between February 27 and November 1, 2020. Confirmed COVID-19 diagnosis was defined by a combination of COVID-19 associated symptoms and either a positive SARS-CoV-2 PCR or a CT-CORADS score ≥4. As primary outcome, the incidence rate of severe COVID-19 ( i.e. confirmed COVID-19 diagnosis requiring hospitalization, and/or resulting in ICU admission or death) was determined. Baseline characteristics and data on COVID-19 course were collected. At present, the total IBD population in South-Limburg is set at 4980 patients.

          Results

          During a follow-up of 3384 person-years, a total of 61 IBD patients (1.22%) presented with COVID-19 associated symptoms at one of the two hospital’s ED. Of these, 18 IBD patients (0.36%; 11 UC, 7 CD) fulfilled the criteria for severe COVID-19, corresponding to an incidence rate of 5.3 per 1000 person-years. Furthermore, 12/18 patients were using immunosuppressive medication for their IBD. Mean age at time of admission was 64.5 years (SD: 10.8) and 55.6% were male. All hospitalized patients had at least one comorbidity (with ≥ 1 comorbidity in 13/18 patients (72.2%)), cardiovascular disease being most prevalent (12/18). Mean BMI at time of admission was 27.3 (SD: 4.2). Thirteen patients (72.2%) required oxygen support and three patients (16.7%) ICU admission (of which two needed mechanical ventilation), translating to an incidence rate of 0.9 per 1000 patient-years for ICU admission. Median length of hospitalization was 11 days (IQR: 5.3–18.3). No IBD patients died due to severe COVID-19.

          Conclusion

          The incidence rate of severe COVID-19 among IBD patients in a population-based setting in a heavily affected region was 5.3 per 1000 person-years. Despite frequent use of immunosuppressive medication and high region-specific mortality rates, clinical outcomes of severe COVID-19 were comparable to the general population and in line with recent literature.

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          Author and article information

          Journal
          J Crohns Colitis
          J Crohns Colitis
          eccojc
          Journal of Crohn's & Colitis
          Oxford University Press (US )
          1873-9946
          1876-4479
          May 2021
          27 May 2021
          : 15
          : Suppl 1 , Abstracts of the 16th Congress of ECCO Virtual, July 2-3 & 8-10, 2021
          : S571-S572
          Affiliations
          [1 ]Department of Internal Medicine- Division of Gastroenterology and Hepatology, Maastricht University Medical Centre+ , Maastricht, The Netherlands
          [2 ]School for Nutrition and Translational Research in Metabolism NUTRIM, Maastricht University Medical Centre+ , Maastricht, The Netherlands
          [3 ]Department of Gastroenterology- Geriatrics- Internal and Intensive Care Medicine, Zuyderland Medical Centre , Sittard-Geleen, The Netherlands
          Article
          jjab076.757
          10.1093/ecco-jcc/jjab076.757
          8194845
          5a5d3a60-c5c4-499a-a1af-cd7e0d472fe1
          Copyright © 2021 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com

          This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

          This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

          History
          Page count
          Pages: 2
          Categories
          Poster Presentations
          Epidemiology
          AcademicSubjects/MED00260

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