Abstract
We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March–July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8–27 and 4.5, 95% CI: 1.3–15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3–11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.
Highlights
The COVID-19 pandemic hit Spain at the end of February 2020 and is far from under complete control
We found that patients 50 years old or older were at greater risk for hospitalization, while those 60 years old or older were more prone to severe COVID-19 or death due to COVID-19
In contrast to SECURE-inflammatory bowel disease (IBD) [8], we did not find that current treatment with systemic steroids was related to a worse COVID-19 evolution, an outcome that we have previously found related to other relevant infections in patients with IBD [3]
Summary
The COVID-19 pandemic hit Spain at the end of February 2020 and is far from under complete control. Experts on IBD, worried by the potential severity of COVID-19 in these patients, recommended, during the initial phases of the pandemic, that whenever possible, starting immunosuppressants should be delayed and treatment deescalated [5,6,7] Notwithstanding this information, more than one year after the start of the pandemic, factors related to deleterious prognosis of COVID-19 in patients with IBD are essentially the same as those of the general population (mainly older age and comorbidities), whereas those on immunosuppressants do not appear to have a greater risk for severe COVID-19, except for corticosteroids [8]. Retrospective studies and registries have important limitations, such as reporting bias, over- or underrepresentation of the more severe cases of COVID-19, and the possibility of including confounding factors that may influence the results
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call