Final Analysis of COVID-19 Patients With Inflammatory Bowel Disease in Japan (J-COSMOS): A Multicenter Registry Cohort Study

Hiroshi Nakase ,Fukunori Kinjo ,Makoto Sasaki ,Ryosuke Sakemi ,Shingo Kato ,Soichiro Ishihara ,Itaru Iwama ,Masayuki Saruta ,Shuji Yamamoto ,Shigeru Iwase ,Toshiaki Shimizu ,Takayuki Matsumoto ,Toshifumi Ashida ,Makoto Naganuma ,Takeo Kondo ,Takehiko Katsurada ,Fumiyoshi Ueno ,Masahiro Iizuka ,Satoshi Motoya ,Yoshikazu Furuta ,Kenji Kinoshita ,Nobuaki Nishimata ,Katsuhiro Arai ,Yuri Etani ,Katuyuki Fukuda ,Yoshihiro Yokoyama ,Fumihito Hirai ,Atsuo Maemoto ,Shirô Nakamura ,Yukihide Maeda ,Yoshihiko Hayashi ,Masakatsu Fukuzawa ,Naoki Yoshimura ,Takayoshi Suzuki ,K Mitsuyama ,Motohiro Esaki ,Hironori Yamamoto ,Minoru Matsuura ,Shunji Ishihara ,Ryota Hokari ,Takeshi Ueda ,Yu Hashimoto ,Naoki Ohmiya ,Takashi Hisabe ,Kenji Watanabe ,Hiroki Tanaka ,Taku Kobayashi ,Masaru Shinozaki ,Hirotake Sakuraba ,Keiji Ozeki ,Yoichi Kakuta ,Tadakazu Hisamatsu ,Daiki Abukawa ,Ken Takeuchi ,Katsuyoshi Matsuoka ,Shinya Yoshikawa ,Ken­ichi Takahashi ,Kazutaka Koganei ,Sakiko Hiraoka ,Ayako Fuchigami ,Noriko Kamata ,Yuji Naito ,Shigeaki Aono ,Mikihiro Fujiya ,Katsuhiko Nakai ,Keiichi Tominaga ,Hideki Iijima ,Kiyonori Kobayashi ,Akira Andoh ,Shojiro Yamamoto ,Reiko Kunisaki ,Masakazu Nagahori ,Michio Itabashi ,Jun Kato ,Takashi Kagaya ,Sohachi Nanjo ,Akira Hokama

doi:10.1016/j.gastha.2023.07.017

Abstract

Japan has experienced 8 waves of the coronavirus disease 2019 (COVID-19) outbreak over the past 3 years, resulting in an increasing number of deaths and incidence of severe infections. This study aimed to analyze the data from the Japanese inflammatory bowel disease (IBD) patients with COVID-19 registry (J-COSMOS) up to the eighth wave to investigate the clinical course of IBD patients with COVID-19 and factors contributing to disease severity. In this multicenter, observational, cohort study, we analyzed a cohort of 1308 IBD patients diagnosed with COVID-19, enrolled across 77 participating facilities in the J-COSMOS registry from June 2020 to December 2022. Data on age, sex, IBD (classification, treatment, and activity), and COVID-19 (symptoms, severity, and treatment) were analyzed. The majority of patients (76%) were in clinical remission. According to the World Health Organization classification of COVID-19 severity, 98.4% of IBD patients had nonsevere disease, while 1.6% of patients had severe or critical disease. COVID-19 did not affect disease activity in most IBD patients. Stepwise logistic regression analysis revealed that high body mass index, and cerebrovascular disease were risk factors for severe COVID-19. Corticosteroids could affect COVID-19 severity, whereas anti-tumor necrosis factor α antibodies and thiopurines were associated with a reduced risk of severe COVID-19. No deaths were observed among IBD patients with COVID-19 registered in this cohort. The impact of COVID-19 on IBD disease activity and factors associated with COVID-19 severity were consistent with findings of previous reports. No deaths in Japanese patients with IBD were observed.

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