Abstract
BackgroundThe COVID-19 pandemic raised concerns among IBD patients fearing an increased risk of infection and poor outcomes. We aimed to evaluate the incidence of COVID-19 among IBD patients; its influence on disease severity and outcome; its relationship to medication use; and how the pandemic affected IBD management.MethodsAn anonymous questionnaire was posted online to members of the Israel Crohn’s Disease and Ulcerative Colitis Foundation (November 2020- January 2021). The questionnaire addressed the course of IBD disease and COVID-19 infection over the past year.Results2152 IBD patients completed the questionnaire. 104 (4.8%) had been infected with COVID-19, significantly lower than the “expected” infected cases among the Israeli population (p=0.033). The median age of participants was 39; 60.5% were female. Most patients (75.6%) had no comorbidities other than IBD.No correlation was found between IBD type or disease severity and COVID-19 infection. Most IBD patients reported mild COVID-19 disease, regardless of the type of IBD medications. Multivariable logistic regression analysis revealed that younger age, elevated BMI, and diabetes were independent risk factors for COVID-19 infection. IBD treatment including 5-aminosalicylic acid, smoking, and hypertension were protective factors. 25.2% of COVID-19 patients discontinued their IBD treatment, compared to 8.5% of non-COVID-19 infected patients. IBD flares were significantly higher in those who discontinued treatment (p<0.001).ConclusionIBD patients do not have an increased risk for COVID-19, regardless of IBD activity or treatment. Patients should be encouraged to continue effective IBD therapy, including biologics and steroids, to minimize active IBD.
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