- Active IBD led to severe complications of COVID-19 (hospitalizations, pneumonia, respiratory support, death)
- Ulcerative colitis increased chances of pneumonia but not death 
- Immunosuppresive therapy did not effect COVID-19 outcome
- Older age contributed to more severe complications 

Smith College

In a prospective, observational cohort study, researchers investigated the effects of COVID-19 in patients with IBD. Specifically, they sought to identify risk factors that predicted the severity and outcomes of infection. 



A Study of COVID-19 Patients with IBD in Italy 

Bezzio, C., Saibeni, S., Variola, A., Allocca, M., Massari, A., Gerardi, V., ... & Caprioli, F. (2020). Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study. Gut, 69(7), 1213-1217.

https://gut.bmj.com/content/69/7/1213

Outcomes of COVID-19 in 79 patients with IBD in
Italy: an IG-IBD study

- 79 COVID-19 patients with IBD in total
- Patients had an established diagnosis of Crohn's disease or Ulcerative Colitis for at least 6 months and had either a confirmed or likely diagnosis of COVID-19 
- Confirmed COVID-19 diagnosis was detected by PCR of a nasopharyngeal swab (49 patients)
- Likely diagnosis was made for a patient who was exposed to an infected person and exhibited three of the following signs/symptoms: fever, cough, dyspnoea, dysosmia,  dysgeusia, or CT scan showing infected lungs (30 patients)



Background of COVID-19 Patients with IBD

- COVID-19 related pneumonia (46%) 
- Hospitalizations (22%)
- Needed nonmechanical ventilation (9%)
- Needed continuous positive airway pressure therapy (11%)
- Died from complications (8%)
- Underwent endotracheal intubation (3%)
- Common Symptoms: fever (90%), cough (66%), dysosmia/dysgeusia (24%), arthralgia/myalgia (23%), dyspnoea (19%), diarrhoea (15%) and rhino-pharyngitis (16%)

IBD Patient Statistics Regarding Severity of COVID-19 Infection 

- 30 patients had at least one comorbidity

    - Hypertension (30%) 
    - Coronary heart disease (16.67%)
    - Chronic obstructive pulmonary disease (16.67%) 
    - Ulcerative colitis + cytomegalovirus colitis (6.67%)
    - Immune mediated diseases (26.67%)
    - Kaposi's sarcoma (3.33%)

Comorbidities present in IBD patients with COVID-19

- A significant difference between patients with Crohn's disease or ulcerative colitis was not observed regarding the medications they were taking
- One patient received both infliximab and azathioprine and did not develop pneumonia
- One patient received triple immunosuppression (steroids+azathioprine+infliximab), had a cytomegalovirus infection, was hospitalized for COVID-19, and developed pneumonia but recovered 

Effects of immunosuppressive drugs in COVID-19 patients with IBD

- 36 patients in total had pneumonia 
    - Ulcerative Colitis (72%)
    - Crohn's Disease (28%)  
    - Hospitalizations (61%) 
    - Deaths (16%)
    - 15 patients had at least one comorbidity 
    - 4 patients who were originally admitted to hospital for an acute severe IBD flare 
      developed pneumonia  
- Risk of pneumonia is greater in patients older than 65 years 
- IBD treatments did not increase the risk of pneumonia 


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