Abstract

Immunosuppressive Therapy and Risk of COVID-19 Infection in Patients With Inflammatory Bowel Diseases

Inflamm Bowel Dis. 2020 Oct 22;izaa278. doi: 10.1093/ibd/izaa278. Online ahead of print.

Kristin E Burke 1 2, Bharati Kochar 1 2, Jessica R Allegretti 2 3, Rachel W Winter 2 3, Paul Lochhead 1 2, Hamed Khalili 1 2, Francis P Colizzo 1 2, Matthew J Hamilton 2 3, Walter W Chan 2 3, Ashwin N Ananthakrishnan 1 2

 
     

Author information

  • 1Crohn's and Colitis Center, Massachusetts General Hospital, Boston, MA.
  • 2Harvard Medical School, Boston, MA.
  • 3Crohn's and Colitis Center, Brigham and Women's Hospital, Boston, MA.

Abstract

Background: The effect of immunosuppressive treatment for immune-mediated diseases on risk of the novel coronavirus disease 2019 (COVID-19) has not been established. We aimed to define the effect of targeted biologic and immunomodulator therapy on risk of COVID-19 in a multi-institutional cohort of patients with inflammatory bowel disease (IBD).

Methods: We identified patients 18 years and older who received care for IBD at Partners Healthcare between January 2019 and April 2020. The primary outcome was development of COVID-19 defined as a positive polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2. Multivariable regression models were used to examine the effect of immunosuppression on risk of COVID-19 and its outcomes.

Results: In a cohort of 5302 IBD patients, 39 (0.7%) developed COVID-19. There was no difference in age, sex, or race between IBD patients with and without COVID-19. The rate of COVID-19 was similar between patients treated with immunosuppression (0.8%) compared with those who were not (0.64%; P = 0.55). After adjusting for age, sex, race, and comorbidities, use of immunosuppressive therapy was not associated with an increased risk of COVID-19 (odds ratio, 1.73; 95% confidence interval, 0.82-3.63). The presence of obesity was associated with a higher risk of COVID-19 (odds ratio, 8.29; 95% confidence interval, 3.72-18.47). There were 7 hospitalizations, 3 intensive care unit stays, and 1 death. Older age and obesity but not immunosuppressive treatment were associated with severe COVID-19 infection.

Conclusions: The use of systemic immunosuppression was not associated with an increased risk of COVID-19 in a multi-institutional cohort of patients with IBD.

© Copyright 2013-2020 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.