Background Patients with Inflammatory Bowel Disease (IBD) suffer from a chronic illness and many of them need immunosuppressive therapy throughout the course of the disease. Consequently, COVID-19 pandemic has caused uncertainty about the possible increased risk of suffering SARS-CoV-2 infection that could confer IBD or its treatments. The aim of this study is to assess SARS-CoV-2 seroprevalence in patients with IBD as well as the existence of potential risk factors for its development. Methods This is a unicentric cross-sectional study developed in IBD unit of University Hospital “Lozano Blesa” of Zaragoza. Patients older than 18 years with established diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis (IC) have been included. A blood sample has been drawn from each patient to detect IgG against SARS-CoV-2 (ELISA method) and each patient has completed a questionnaire to know symptoms related to infection and previous comorbidity. We have performed a descriptive analysis and a univariate analysis to study relationship between potential risk factors and seroconversion against SARS-CoV-2. Results 431 patients have been included, with a mean age of 50.2 ± 14.1 years and a 51.3% of women. Of them, 49.7% suffer from UC, 49.2% CD and 1.2% IC. Related to the treatment, 23.5% receive anti-TNF biologic agents, 13.1% other kind of biologic agents, 9.3% immunomodulators, 7.7% combined treatment (biologic agent and immunomodulator), 33.1% other treatment and 13.3% no treatment. According to World Health Organization (WHO) definitions, 85.6% had not suffered the infection, 7.7% were confirmed cases (only 3 admitted patients) and 6.7% were probable cases. The seroprevalence of SARS-CoV-2 obtained is 8.8%, being significantly higher among confirmed cases than among probable cases (71.0% in confirmed vs 6.9% in probable; RR 10.3; p<0.001). A higher risk of seroconversion has been detected among patients without biologic agents (11.8% in patients without biologic agents vs 5.3% in patients with biologic agents; RR 2.2; p=0.021). No differences have been observed in the seroprevalence of patients with other treatments for IBD or in terms of age, active smoking, level of inflammation markers, the presence of symptoms of infection or hospital admission. Conclusion The seroprevalence of SARS-CoV-2 of Aragon′s patients with IBD is similar to that described in national seroprevalence study of Ministry of Health for the region (8.8%). The treatment with biologic agents is associated with a lower risk of seroconversion
Background The lockdown period due to the coronavirus disease 2019 (COVID-19) in Spain was established from 16th March to 21th June 2020. Therefore, the authorities controlled personal movements and private and public non-essential activities were cancelled. It has probably had an important emotional impact on chronic patients and hence in those who are suffering from Inflammatory Bowel Disease (IBD) due to their high risk of emotional disorders. The aim of this study is to know how COVID 19 influenced to the patients suffering from IBD during the quarantine period, focusing heavily on the psychological distress through the Perceived Stress Scale-10 (PSS-10), and also the impact of the pandemic on therapeutic adherence using Visual Analogue Scale (VAS). Methods This is an unicentric and analytical observational study carried out in IBD unit of a large public teaching Hospital (University Hospital “Lozano Blesa”) during August 2020. Patients were contacted and interviewed by phone by two trained researchers not involved in the patient′s medical care. Inclusion criteria were age ≥ 18 years old and confirmed diagnosis of Crohn′s Disease (CD), Ulcerative Colitis (UC) or Indeterminate Colitis. A descriptive analysis was carried out and, subsequently, the factors associated with the loss of therapeutic adherence and higher-moderate levels of stress were analyzed through Logistic regression multivariate analyses. Results Of the 426 patients included, 217 (50.9%) were women, 249 (58.4%) had UC and 177 (41.6%) had EC. During the Spanish lockdown period, most of patients did not have symptoms related to their IBD (302; 72.1%). Among those who had symptoms, the most frequent was diarrhea and abdominal pain (11.5%). Most of subjects were not diagnosed of SARS-CoV2 infection (93%), whereas 2.1% suffered confirmed infection and 4.9% had compatible symptoms without test confirmation. Regarding economic situation of patients, most of them did not have economic difficulties (87.6%). Moreover, 74.4% of participants referred a very good physician-patient relationship and 21.8% a good relationship. People who participated in the study had a median PSS-10 score of 12 (10–16). A higher level of stress was reported between those who were not married, women, and those who experimented an increase of IBD related symptoms. Adherence to treatment was not associated with stress level based on PSS-10 questionnaire. Conclusion Although the lockdown period due to COVID-19 pandemic has probably had an important emotional impact on Spanish population, IBD patients had in general lower PSS-10 scores. It could be due to a good patient-physician relationship, which contributed to maintaining a good adherence to medications in those patients.
Background Plasma glycoproteins are acute-phase proteins, which can contribute to the development of many complex inflammatory diseases as Inflammatory Bowel Disease (IBD). Glycoprotein concentration as measured by nuclear magnetic resonance (NMR) spectroscopy has been proposed as a biomarker for monitoring activity of IBD, but has been also related to metabolic syndrome. Our goal is to further define the role of this new biomarker in IBD patients with MAFLD. Methods Prospective cohort study of consecutive IBD outpatients (Leonnard-Jones criteria, > 1 year) seen at reference centre, was performed from October 2020 to April 2021. Of 947 outpatients, 50 patients with IBD who met criteria for MAFLD and 50 patients with IBD and without MAFLD were matched by sex, age and IBD severity. Every IBD patient was also matched with 4 controls without IBD. Patients and controls with a previous diagnosis of CV disease, type II diabetes mellitus and under treatment for dyslipidaemia were excluded. Serum samples were analysed by NRM Spectroscopy with glycoprotein (Glyc-B, Glyc-F and Glyc-A) analysis by Biosfer Teslab, Spain. Demographic, clinical, biochemical and anthropomorphic variables were obtained prospectively in all cases. Wilcoxon Rank-sum test was used for comparison between groups with R (v 4.1.1). Results A total of 100 IBD patients and 400 controls were included. The median age were 51.0 (41–59) years old for each group. There were no differences in body mass index (BMI) between groups (26.4 (23.1–29.9) for IBD and 27.1 (24.4–30.4) for controls p=0.130). Regarding IBD patients, 49 (49%) had ulcerative colitis (UC) and 51(51%) Crohn’s disease (CD). Both IBD groups (with or without MAFLD) were well-matched excepting BMI as expected (table 1). Glycoprotein concentrations were significatively higher in IBD when compared to controls (table 2, p<0.001). In IBD patients with MAFLD glycoprotein concentrations were the highest (p<0.001) with no overlap with controls (table 3). Conclusion This prospective study confirms that glycoprotein concentrations can be a biomarker in IBD and for the first time suggests that it can be a very useful biomarker to identify MAFLD.
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