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Risk factors for severe COVID-19 among IBD patients

Presented by
Dr Ryan C. Ungaro, Icahn School of Medicine at Mount Sinai, USA
UEGW 2020


Increasing age, comorbidities, and corticosteroids are associated with severe COVID-19 among IBD patients, according to a large, international registry created to monitor outcomes of IBD patients with confirmed COVID-19, called SECURE-IBD [1]. Notably, use of TNF antagonists does not appear to be associated with severe COVID-19.

The impact of COVID-19 on patients with inflammatory bowel disease (IBD) is not well characterised. The SECURE-IBD survey catalogued the clinical course of COVID-19 among IBD patients and evaluated the association between demographics, clinical characteristics, and immunosuppressant treatments on COVID-19 outcomes.

Reported were 959 COVID-19 cases from 40 countries (median age 43 years, 52% men). Of those, 86 patients (9%) had severe COVID-19, 320 (33%) were hospitalised, and 37 patients died (3.9% case fatality rate). Age-standardised mortality ratios for IBD patients were:

  • 0 relative to data from China;
  • 7 relative to data from Italy; and
  • 9 relative to data from the US.

Furthermore, the investigators aimed to identify factors associated with severe COVID-19, defined as intensive care unit admission, ventilator use, and/or death, using multivariable logistic regression.

Risk factors found for severe COVID-19 among IBD patients in the current study included:

  • increasing age: adjusted odds ratio (aOR) 1.04;
  • 1 comorbidity in addition to IBD: aOR 2.60;
  • ≥2 comorbidities: aOR 4.8;
  • systemic corticosteroids: aOR 5.1; and
  • sulfasalazine or 5-aminosalicylate use: aOR 2.0.

In contrast, TNF antagonist treatment was not associated with severe COVID-19 (aOR 0.9).

The SECURE-IBD registry showed an association between increasing age, comorbidities, and corticosteroids and severe COVID-19 among IBD patients. Nevertheless, no association was found for TNF antagonists with severe COVID-19.

  1. Ungaro R. Impact of COVID-19 on patients with inflammatory bowel disease: data from an international registry. UEG Week Virtual Symposium 2020, abstract OP153.

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