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. 2021 Oct 5;16(10):e0258271.
doi: 10.1371/journal.pone.0258271. eCollection 2021.

Severe COVID-19 in inflammatory bowel disease patients in a population-based setting

Rob H Creemers  1   2 , Ashkan Rezazadeh Ardabili  2   3 , Daisy M Jonkers  2   3 , Mathie P G Leers  4 , Mariëlle J Romberg-Camps  1 , Marie J Pierik  2   3 , Ad A van Bodegraven  1
Affiliations

Severe COVID-19 in inflammatory bowel disease patients in a population-based setting

Rob H Creemers et al. PLoS One. .

Abstract

Objective: Data on the course of severe COVID-19 in inflammatory bowel disease (IBD) patients remains limited. We aimed to determine the incidence rate and clinical course of severe COVID-19 in the heavily affected South-Limburg region in the Netherlands.

Methods: All COVID-19 patients admitted to the only two hospitals covering the whole South-Limburg region between February 27, 2020 and January 4, 2021 were included. Incidence rates for hospitalization due to COVID-19 were determined for the IBD (n = 4980) and general population (n = 597,184) in South-Limburg.

Results: During a follow-up of 4254 and 510,120 person-years, 20 IBD patients (0.40%; 11 ulcerative colitis (UC), 9 Crohn's disease (CD)) and 1425 (0.24%) patients from the general population were hospitalized due to proven COVID-19 corresponding to an incidence rate of 4.7 (95% Confidence interval (CI) 3.0-7.1) and 2.8 (95% CI 2.6-2.9) per 1000 patient years, respectively (Incidence rate ratio: 1.68, 95% CI 1.08-2.62, p = 0.019). Median age (IBD: 63.0 (IQR 58.0-75.8) years vs. general population: 72.0 (IQR 62.0-80.0) years, p = 0.10) and mean BMI (IBD: 24.4 (SD 3.3) kg/m2 vs. general population 24.1 (SD 4.9) kg/m2, p = 0.79) at admission were comparable in both populations. As for course of severe COVID-19, similar rates of ICU admission (IBD: 12.5% vs. general population: 15.7%, p = 1.00), mechanical ventilation (6.3% vs. 11.2%, p = 1.00) and death were observed (6.3% vs. 21.8%, p = 0.22).

Conclusion: We found a statistically significant higher rate of hospitalization due to COVID-19 in IBD patients in a population-based setting in a heavily impacted Dutch region. This finding reflects previous research that showed IBD patients using systemic medication were at an increased risk of serious infection. However, although at an increased risk of hospitalization, clinical course of severe COVID-19 was comparable to hospitalized patients without IBD.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: AvB has served as speaker, adviser and/or principal investigator for AbbVie, Arandal, Arena, Celgene, Ferring, Galapagos, Janssen, MSD, Pfizer, Roche, Takeda, TEVA, and received research grants from TEVA, Eurostars funding, ZonMW, all outside the submitted work. MP reports grants and non-financial support from Falk Pharma, grants from European commission, grants from ZONMW (Dutch national research fund), grants and non-financial support from Takeda, grants and non-financial support from Johnson and Johnson, grants and non-financial support from Abbvie, non-financial support from Ferring, non-financial support from Immunodiagnostics, non-financial support from MSD, all outside the submitted work. DJ reports grants from Top Knowledge Institute (Well on Wheat), grants from Horizon 2020 DISCOvERIE, grants from NWO-CCC Partnership program (Carbokinetics), all outside the submitted work. ARA, RC, ML and MRC have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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References

    1. Kirchgesner J, Lemaitre M, Carrat F, Zureik M, Carbonnel F, Dray-Spira R. Risk of Serious and Opportunistic Infections Associated With Treatment of Inflammatory Bowel Diseases. Gastroenterology. 2018;155(2):337–46.e10. doi: 10.1053/j.gastro.2018.04.012 - DOI - PubMed
    1. Kucharzik T, Ellul P, Greuter T, Rahier JF, Verstockt B, Abreu C, et al.. ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. Journal of Crohn’s and Colitis. 2021. - PubMed
    1. Hindryckx P, Novak G, Bonovas S, Peyrin-Biroulet L, Danese S. Infection Risk With Biologic Therapy in Patients With Inflammatory Bowel Disease. Clinical pharmacology and therapeutics. 2017;102(4):633–41. doi: 10.1002/cpt.791 - DOI - PubMed
    1. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al.. Clinical Characteristics of Coronavirus Disease 2019 in China. The New England journal of medicine. 2020;382(18):1708–20. doi: 10.1056/NEJMoa2002032 - DOI - PMC - PubMed
    1. Singh AK, Jena A, Kumar-M P, Sharma V, Sebastian S. Risk and outcomes of coronavirus disease in patients with inflammatory bowel disease: A systematic review and meta-analysis. United European Gastroenterology Journal. 2021;9(2):159–76. doi: 10.1177/2050640620972602 - DOI - PMC - PubMed

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