Interim analysis of a multicenter registry study of COVID-19 patients with inflammatory bowel disease in Japan (J-COSMOS)

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

doi:10.1007/s00535-022-01851-1

Abstract

BackgroundThe spread of coronavirus disease 2019 (COVID-19) had a major impact on the health of people worldwide. The clinical background and clinical course of inflammatory bowel disease (IBD) among Japanese patients with COVID-19 remains unclear.MethodsThis study is an observational cohort of Japanese IBD patients diagnosed with COVID-19. Data on age, sex, IBD (classification, treatment, and activity), COVID-19 symptoms and severity, and treatment of COVID-19 were analyzed.ResultsFrom 72 participating facilities in Japan, 187 patients were registered from June 2020 to October 2021. The estimated incidence of COVID19 in Japanese IBD patients was 0.61%. The majority of IBD patients with COVID-19 (73%) were in clinical remission. According to the WHO classification regarding COVID-19 severity, 93% (172/184) of IBD patients had non-severe episodes, while 7% (12/184) were severe cases including serious conditions. 90.9% (165/187) of IBD patients with COVID-19 had no change in IBD disease activity. A logistic regression analysis stepwise method revealed that older age, higher body mass index (BMI), and steroid use were independent risk factors for COVID-19 severity. Six of nine patients who had COVID-19 after vaccination were receiving anti-tumor necrosis factor (TNF)-α antibodies.ConclusionAge, BMI and steroid use were associated with COVID-19 severity in Japanese IBD patients.

Highlights

The rapid spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the resulting coronavirus disease (COVID-19) have impacted patients and healthcare workers in clinical settings [1,2,3]
SARS-CoV-2 infection could affect the clinical course of inflammatory bowel disease (IBD) patients, in whom intestinal inflammation is central to the pathogenesis and who require immunosuppressive therapy
We found that 90.9% (165/187) of IBD patients with COVID-19 had no change in IBD disease activity. (Supplementary Fig. 2)

Summary

Introduction

The rapid spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the resulting coronavirus disease (COVID-19) have impacted patients and healthcare workers in clinical settings [1,2,3]. Chronic intestinal inflammation is among the indications of inflammatory bowel disease (IBD), with an increasing prevalence rate among Japanese patients since 1950 [14]. SARS-CoV-2 infection could affect the clinical course of IBD patients, in whom intestinal inflammation is central to the pathogenesis and who require immunosuppressive therapy. The clinical background and clinical course of inflammatory bowel disease (IBD) among Japanese patients with COVID-19 remains unclear

Methods

Results

Conclusion