2019 novel coronavirus disease (COVID-19) in patients with inflammatory bowel diseases

Aliment Pharmacol Ther. 2020 Jul;52(2):276-283. doi: 10.1111/apt.15804. Epub 2020 Jun 7.

Abstract

Background: Data on patients with inflammatory bowel diseases (IBD) who have had 2019 novel coronavirus (SARS-CoV-2) disease (COVID-19) are needed.

Aims: To report the clinical characteristics, including gastrointestinal symptoms, of COVID-19 in IBD patients, and to assess the risk of COVID-19 in IBD.

Methods: This case series included consecutive IBD patients with laboratory-confirmed COVID-19. Age-adjusted cumulative incidences were compared with the general population in the Madrid region.

Results: Through April 8, 12 of 1918 IBD patients were diagnosed with COVID-19. The average age was 52 years, 75% of the patients were female and 58.3% had Crohn's disease. Seven patients (58%) were on maintenance treatment with immunomodulators/biologics, of these four with combined therapy (33%). Eight patients (66%) required hospitalisation (one intensive care unit admission, and two deaths), and four patients were isolated at home. Nine patients had diarrhoea ranging between 4 and 10 loose stools per day (mean 5.4, SD 1.6). In five patients (42%) diarrhoea was a presenting symptom. In two patients, diarrhoea was the only symptom at debut. Cumulative incidence of COVID-19 was 6.2 per 1000 IBD patients. IBD patients had a lower adjusted incidence ratio of COVID-19 (OR 0.74, 95% CI 0.70-0.77; P < 0.001), and a similar associated mortality ratio (OR 0.95, 95% CI: 0.84-1.06; P = 0.36), compared with the general population.

Conclusions: IBD patients do not have an increased risk of COVID-19 and associated mortality compared with the general population. In many IBD patients, diarrhoea was a presenting symptom, and sometimes, was the only symptom at onset of COVID-19.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Betacoronavirus / isolation & purification
  • Biological Products / administration & dosage
  • COVID-19
  • Coronavirus Infections / epidemiology*
  • Crohn Disease / epidemiology*
  • Crohn Disease / physiopathology
  • Female
  • Hospitalization
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Incidence
  • Inflammatory Bowel Diseases / epidemiology*
  • Inflammatory Bowel Diseases / physiopathology
  • Intensive Care Units
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral / epidemiology*
  • SARS-CoV-2

Substances

  • Biological Products
  • Immunologic Factors