Incidence, Clinical Characteristics, and Evolution of SARS-CoV-2 Infection in Patients With Inflammatory Bowel Disease: A Single-Center Study in Madrid, Spain

Inflamm Bowel Dis. 2021 Jan 1;27(1):25-33. doi: 10.1093/ibd/izaa221.

Abstract

Background: There are scarce data about SARS-CoV-2 infection in patients with inflammatory bowel disease (IBD). Our aim was to analyze the incidence, clinical presentation, and severity of SARS-CoV-2 infection in patients with IBD.

Methods: This is a cross-sectional, observational study. We contacted all the patients being treated at our IBD unit to identify those patients with suspected or confirmed SARS-CoV-2 infection, following the World Health Organization case definition. Data were obtained by patient electronical medical records and by phone interview.

Results: Eighty-two of 805 patients with IBD (10.2%; 95% confidence interval [CI], 8.3-12.5) were diagnosed as having confirmed (28 patients, 3.5%; 95% CI, 2.4-5.0) or suspected (54 patients, 6.7%) infection. Patient age was 46 ± 14 years, 44 patients were female (53.7%), 17.3% were smokers, 51.2% had Crohn disease (CD), and 39.0% had comorbidities. Digestive symptoms were reported in 41 patients (50.0%), with diarrhea as the most common (42.7%). One patient (1.2%) was diagnosed with IBD flare-up during SARS-CoV-2 infection. Twenty-two patients (26.8%) temporarily withdrew from their IBD treatment because of COVID-19. Most of the patients had mild disease (79.3%), and 1 patient died (1.2%). In the multivariate analysis, the presence of dyspnea was associated with moderate to severe infection (odds ratio, 5.3; 95% CI, 1.6-17.7; P = 0.01) and myalgias (odds ratio, 4.8; 95% CI, 1.3-17.9; P = 0.02) were related to a milder clinical course. Immunosuppression was not related to severity.

Conclusions: SARS-CoV-2 infection in patients with IBD is not rare. Dyspnea is associated with a more severe infection. Therapy for IBD, including immunomodulators and biologic therapy, is not related to a greater severity of COVID-19, and SARS-CoV-2 infections do not appear to be related to IBD flare-ups.

Keywords: COVID-19; SARS-CoV-2; immunosuppression; incidence; inflammatory bowel disease.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Biological Therapy / methods
  • COVID-19 / epidemiology*
  • COVID-19 Drug Treatment
  • Cross-Sectional Studies
  • Dyspnea / etiology
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Immunologic Factors / therapeutic use
  • Incidence
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology*
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Factors
  • Spain / epidemiology

Substances

  • Immunologic Factors
  • Hydroxychloroquine