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COVID-19 susceptibility and clinical outcomes in inflammatory bowel disease: An updated systematic review and meta-analysis |
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| Authors: | Min Ho Lee Han Jacob Li Paul Wasuwanich Sung Eun Kim Jong Yeob Kim Gwang Hun Jeong Seoyeon Park Jae Won Yang Min Seo Kim Dong Keon Yon Seung Won Lee Ai Koyanagi Louis Jacob Eun-Young Kim Jae Hee Cheon Jae Il Shin Lee Smith |
| Affiliation: | 1. Yonsei University College of Medicine, Seoul, Republic of Korea;2. University of Florida College of Medicine, University of Florida, Gainesville, Florida, USA;3. Gyeongsang National University College of Medicine, Jinju, Republic of Korea;4. Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea;5. Department of Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea;6. Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea;7. Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea;8. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain ICREA, Barcelona, Spain;9. Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Barcelona, Spain Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain;10. Department of Health, Social and Clinical Pharmacy, Evidence-Based and Clinical Research Laboratory, College of Pharmacy, Chung-Ang University, Seoul, Korea;11. Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;12. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea;13. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK |
| Abstract: | The susceptibility, risk factors, and prognosis of COVID-19 in patients with inflammatory bowel disease (IBD) remain unknown. Thus, our study aims to assess the prevalence and clinical outcomes of COVID-19 in IBD. We searched PubMed, EMBASE, and medRxiv from 2019 to 1 June 2022 for cohort and case-control studies comparing the prevalence and clinical outcomes of COVID-19 in patients with IBD and in the general population. We also compared the outcomes of patients receiving and not receiving 5-aminosalicylates (ASA), tumour necrosis factor antagonists, biologics, systemic corticosteroids, or immunomodulators for IBD. Thirty five studies were eligible for our analysis. Pooled odds ratio of COVID-19-related hospitalisation, intensive care unit (ICU) admission, or death in IBD compared to in non-IBD were 0.58 (95% confidence interval (CI) = 0.28–1.18), 1.09 (95% CI = 0.27–4.47), and 0.67 (95% CI = 0.32–1.42), respectively. Inflammatory bowel disease was not associated with increased hospitalisation, ICU admission, or death. Susceptibility to COVID-19 did not increase with any drugs for IBD. Hospitalisation, ICU admission, and death were more likely with 5-ASA and corticosteroid use. COVID-19-related hospitalisation (Odds Ratio (OR): 0.53; 95% CI = 0.38–0.74) and death (OR: 0.13; 95% CI = 0.13–0.70) were less likely with Crohn's disease than ulcerative colitis (UC). In conclusion, IBD does not increase the mortality and morbidity of COVID-19. However, physicians should be aware that additional monitoring is needed in UC patients or in patients taking 5-ASA or systemic corticosteroids. |
| Keywords: | COVID-19 Crohn's disease inflammatory bowel disease meta-analysis ulcerative colitis |