COVID-19 and Outcomes in Patients With Inflammatory Bowel Disease : Systematic Review and Meta-Analysis
© 2021 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: Our understanding of coronavirus disease 2019 (COVID-19) and its implications for patients with inflammatory bowel diseases (IBD) is rapidly evolving. We performed a systematic review and meta-analysis to investigate the epidemiology, clinical characteristics, and outcomes in IBD patients with COVID-19.
METHODS: We searched PubMed, EMBASE, Cochrane Central, Clinicaltrials.gov, Web of Science, MedRxiv, and Google Scholar from inception through October 2020. We included studies with IBD patients and confirmed COVID-19. Data were collected on the prevalence, patient characteristics, pre-infection treatments for IBD, comorbidities, hospitalization, intensive care unit (ICU), admission, and death.
RESULTS: Twenty-three studies with 51,643 IBD patients and 1449 with COVID-19 met our inclusion criteria. In 14 studies (n = 50,706) that included IBD patients with and without COVID-19, the prevalence of infection was 1.01% (95% confidence interval [CI], 0.92-1.10). Of IBD patients with COVID-19, 52.7% had Crohn's disease, 42.2% had ulcerative colitis, and 5.1% had indeterminate colitis. Nine studies (n = 687) reported outcomes according to IBD therapy received. Compared with patients on corticosteroids, those on antitumor necrosis factor (anti-TNF) therapy had a lower risk of hospitalization (risk ratio [RR], 0.24; 95% CI, 0.16-0.35; P < .01; I2 = 0%) and ICU admission (RR, 0.10; 95% CI, 0.03-0.37; P < .01) but not death (RR, 0.16; 95% CI, 0.02-1.71; P = .13; I2 = 39%). Compared with patients on mesalamine, those on antitumor necrosis factor therapy had a lower risk of hospitalizations (RR, 0.37; 95% CI, 0.25-0.54), ICU admissions (RR, 0.20; 95% CI, 0.07-0.58), and death (0.21; 95% CI, 0.04-1.00). Comparing patients on immunomodulators vs mesalamine or anti-TNF therapy, there was no difference in these outcomes.
CONCLUSIONS: The prevalence of COVID-19 in IBD patients was low. Use of corticosteroids or mesalamine was significantly associated with worse outcomes, whereas use of anti-TNFs was associated with more favorable outcomes. Further investigation clarifying the mechanisms of these disparate observations could help identify risk and adverse outcome-mitigating strategies for patients with IBD.
Errataetall: |
CommentIn: Inflamm Bowel Dis. 2022 Feb 22;:. - PMID 35191988 |
---|---|
Medienart: |
E-Artikel |
Erscheinungsjahr: |
2022 |
---|---|
Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
---|---|
Enthalten in: |
Inflammatory bowel diseases - 28(2022), 8 vom: 01. Aug., Seite 1265-1279 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Tripathi, Kartikeya [VerfasserIn] |
---|
Links: |
---|
Anmerkungen: |
Date Completed 02.08.2022 Date Revised 21.10.2022 published: Print CommentIn: Inflamm Bowel Dis. 2022 Feb 22;:. - PMID 35191988 Citation Status MEDLINE |
---|
doi: |
10.1093/ibd/izab236 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM332568571 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM332568571 | ||
003 | DE-627 | ||
005 | 20231225215834.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231225s2022 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1093/ibd/izab236 |2 doi | |
028 | 5 | 2 | |a pubmed24n1108.xml |
035 | |a (DE-627)NLM332568571 | ||
035 | |a (NLM)34718595 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Tripathi, Kartikeya |e verfasserin |4 aut | |
245 | 1 | 0 | |a COVID-19 and Outcomes in Patients With Inflammatory Bowel Disease |b Systematic Review and Meta-Analysis |
264 | 1 | |c 2022 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 02.08.2022 | ||
500 | |a Date Revised 21.10.2022 | ||
500 | |a published: Print | ||
500 | |a CommentIn: Inflamm Bowel Dis. 2022 Feb 22;:. - PMID 35191988 | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2021 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
520 | |a BACKGROUND: Our understanding of coronavirus disease 2019 (COVID-19) and its implications for patients with inflammatory bowel diseases (IBD) is rapidly evolving. We performed a systematic review and meta-analysis to investigate the epidemiology, clinical characteristics, and outcomes in IBD patients with COVID-19 | ||
520 | |a METHODS: We searched PubMed, EMBASE, Cochrane Central, Clinicaltrials.gov, Web of Science, MedRxiv, and Google Scholar from inception through October 2020. We included studies with IBD patients and confirmed COVID-19. Data were collected on the prevalence, patient characteristics, pre-infection treatments for IBD, comorbidities, hospitalization, intensive care unit (ICU), admission, and death | ||
520 | |a RESULTS: Twenty-three studies with 51,643 IBD patients and 1449 with COVID-19 met our inclusion criteria. In 14 studies (n = 50,706) that included IBD patients with and without COVID-19, the prevalence of infection was 1.01% (95% confidence interval [CI], 0.92-1.10). Of IBD patients with COVID-19, 52.7% had Crohn's disease, 42.2% had ulcerative colitis, and 5.1% had indeterminate colitis. Nine studies (n = 687) reported outcomes according to IBD therapy received. Compared with patients on corticosteroids, those on antitumor necrosis factor (anti-TNF) therapy had a lower risk of hospitalization (risk ratio [RR], 0.24; 95% CI, 0.16-0.35; P < .01; I2 = 0%) and ICU admission (RR, 0.10; 95% CI, 0.03-0.37; P < .01) but not death (RR, 0.16; 95% CI, 0.02-1.71; P = .13; I2 = 39%). Compared with patients on mesalamine, those on antitumor necrosis factor therapy had a lower risk of hospitalizations (RR, 0.37; 95% CI, 0.25-0.54), ICU admissions (RR, 0.20; 95% CI, 0.07-0.58), and death (0.21; 95% CI, 0.04-1.00). Comparing patients on immunomodulators vs mesalamine or anti-TNF therapy, there was no difference in these outcomes | ||
520 | |a CONCLUSIONS: The prevalence of COVID-19 in IBD patients was low. Use of corticosteroids or mesalamine was significantly associated with worse outcomes, whereas use of anti-TNFs was associated with more favorable outcomes. Further investigation clarifying the mechanisms of these disparate observations could help identify risk and adverse outcome-mitigating strategies for patients with IBD | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Meta-Analysis | |
650 | 4 | |a Systematic Review | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a CD | |
650 | 4 | |a COVID-19 | |
650 | 4 | |a IBD | |
650 | 4 | |a UC | |
650 | 4 | |a antitumor necrosis factors | |
650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
650 | 7 | |a Tumor Necrosis Factor Inhibitors |2 NLM | |
650 | 7 | |a Mesalamine |2 NLM | |
650 | 7 | |a 4Q81I59GXC |2 NLM | |
700 | 1 | |a Godoy Brewer, Gala |e verfasserin |4 aut | |
700 | 1 | |a Thu Nguyen, Minh |e verfasserin |4 aut | |
700 | 1 | |a Singh, Yuvaraj |e verfasserin |4 aut | |
700 | 1 | |a Saleh Ismail, Mohamed |e verfasserin |4 aut | |
700 | 1 | |a Sauk, Jenny S |e verfasserin |4 aut | |
700 | 1 | |a Parian, Alyssa M |e verfasserin |4 aut | |
700 | 1 | |a Limketkai, Berkeley N |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Inflammatory bowel diseases |d 1995 |g 28(2022), 8 vom: 01. Aug., Seite 1265-1279 |w (DE-627)NLM094498598 |x 1536-4844 |7 nnns |
773 | 1 | 8 | |g volume:28 |g year:2022 |g number:8 |g day:01 |g month:08 |g pages:1265-1279 |
856 | 4 | 0 | |u http://dx.doi.org/10.1093/ibd/izab236 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 28 |j 2022 |e 8 |b 01 |c 08 |h 1265-1279 |