Abstract

Systematic review on IBD patients with COVID-19: it is time to take stock

Clin Gastroenterol Hepatol. 2020 Aug 7;S1542-3565(20)31080-6.doi: 10.1016/j.cgh.2020.08.003. Online ahead of print.

Ferdinando D'Amico 1, Silvio Danese 2, Laurent Peyrin-Biroulet 3

 
     

Author information

  • 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.
  • 2Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Rozzano Milan, Italy.
  • 3Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. Electronic address: peyrinbiroulet@gmail.com.

Abstract

Background and aims: Clinical characteristics' data of patients with inflammatory bowel diseases (IBD) with COVID-19 are scarce. Aim of our systematic review was to investigate symptoms and diagnostic-therapeutic management of IBD patients with COVID-19.

Methods: We searched Pubmed, Embase, Web of Science, and MedRxiv up to July 29, 2020, to identify all studies reporting clinical information on adult and pediatric IBD patients with confirmed COVID-19.

Results: Twenty-three studies met our inclusion criteria including 243,760 IBD patients. COVID-19 was diagnosed in 1,028 patients (509 Crohn's disease (49.5%), 428 ulcerative colitis (41.6%), 49 indeterminate colitis (4.8%), and 42 missing data (4.1%)) accounting for a cumulative prevalence of 0.4%. Viral infection occurred more frequently in males than in females (56.5% vs 39.7%) and mean age ranged from 14 to 85 years. The most common symptoms were fever (48.3%), cough (46.5%), and diarrhea (20.5%) and COVID-19 diagnosis was mainly achieved through polymerase chain reaction (PCR) analysis of nasopharyngeal swabs (94.4%) and chest computed tomography scans (38.9%). Hydroxychloroquine (23.9%), lopinavir/ritonavir (8.2%), steroids (3.2%), and antibiotics (3.1%) were the most used drugs. Overall, about a third of patients were hospitalized (30.6%) and 11.4% of them required admission to intensive care unit. In total, 29 COVID-19-related deaths were reported (3.8%) and increasing age and presence of comorbidities were recognized as risk factors for COVID-19 and negative outcomes.

Conclusion: Diarrhea occurs more frequently in IBD patients with COVID-19 than in non-IBD population. Further studies are needed to define the optimal diagnostic-therapeutic approach in IBD patients with COVID-19.

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