Incidence of SARS‐CoV‐2 infection in inflammatory bowel disease

Mh, Lee; Ng, CH; Chin, Yip Han; Muthiah, Mark; Foo, FJ; Chong, Choon Seng

doi:10.1111/jgh.15191

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…Moreover, the risk of COVID-19 hospitalization was significantly higher among patients with UC (p < 0.00001). The severe nature of disease, high level of immunosuppression, and higher hospitalization rate might have contributed to a significantly higher rate of COVID-associated hospitalization and severity in patients with UC than CD 107 , 111 .…”

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Abdulla

Mohammed

AlQamish

et al. 2022

Sci Rep

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There is conflicting evidence concerning the effect of inflammatory bowel disease (IBD) on COVID-19 incidence and outcome. Hence, we aimed to evaluate the published evidence through a systematic review process and perform a meta-analysis to assess the association between IBD and COVID-19. A compressive literature search was performed in PubMed/Medline, Scopus, Embase, and Cochrane Library from inception to July 2021. A snowball search in Google, Google Scholar, Research Gate, and MedRxiv; and bibliographic research were also performed to identify any other relevant articles. Quantitative observational studies such as cohort, cross-sectional, and case–control studies that assessed the incidence, risk, and outcomes of COVID-19 among the adult IBD patients published in the English language, were considered for this review. The incidence and risk of COVID-19, COVID-19 hospitalization, the severity of COVID-19, and mortality were considered as the outcomes of interest. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment. A subgroup and sensitivity analysis were performed to explore the heterogeneity and robustness of the results, respectively. A total of 86 studies out of 2828 non-duplicate records were considered for this meta-analysis. The studies were single or multicentric internationally from settings such as IBD centres, medical colleges, hospitals, or from the general public. Most of the studies were observed to be of good quality with an acceptable risk of bias. The pooled prevalence of COVID-19, COVID-19 hospitalization, severe COVID-19, and mortality in the IBD population were 6.10%, 10.63%, 40.43%, and 1.94%, respectively. IBD was not significantly (p > 0.05) associated with the risk of COVID-19, COVID-19 hospitalization, severe COVID-19, and mortality. In contrast, ulcerative colitis was significantly associated with a higher risk of COVID-19 (OR 1.37; p = 0.01), COVID-19 hospitalization (OR 1.28; p < 0.00001), and severe COVID-19 (OR 2.45; p < 0.0007). Crohn’s disease was significantly associated with a lesser risk of severe COVID-19 (OR 0.48; p = 0.02). Type of IBD was a potential factor that might have contributed to the higher level of heterogeneity. There was a significant association between ulcerative colitis and increased risk of COVID-19, COVID-19 hospitalization, and severe COVID-19 infection. This association was not observed in patients with Crohns' disease or in those diagnosed non-specifically as IBD.

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Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Abdulla

Mohammed

AlQamish

et al. 2022

Sci Rep

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“… 15 , 61 Previous systematic reviews have thus far found no increased susceptibilities to COVID‐19 but increased hospitalisation, ICU admission, and mortality with 5‐ASA or corticosteroids. 15 , 62 , 63 …”

Section: Discussionmentioning

confidence: 99%

COVID‐19 susceptibility and clinical outcomes in inflammatory bowel disease: An updated systematic review and meta‐analysis

Lee

Wasuwanich

et al. 2022

Reviews in Medical Virology

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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.

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“…The prevention and treatment of postoperative CD remains challenging in clinical practice and biologics provide an alternative therapy even in the era of coronavirus disease 2019 (COVID‐19) 45 . While the exact pathophysiologyof POR remains unclear, 46 it has been estimated that recurrence occurs in up to 70%‐90% of patients without prompt interventions after surgery 5,47 .…”

Section: Discussionmentioning

confidence: 99%

Quantifying the rate of recurrence of postoperative Crohn's disease with biological therapy. A meta‐analysis

Jain

Chin

et al. 2021

J of Digest Diseases

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Objective Preventing the postoperative recurrence (POR) of Crohn's disease (CD) poses a significant challenge to clinicians. With the advent of biologics, various studies have observed a reduction of recurrence after surgery. Hence, we performed a systematic review and meta‐analysis to identify the rate of POR at different time points in the era of biologic use. Methods We performed a literature search using Medline and Embase databases for studies investigating biologics in preventing the POR of CD. Data were extracted, and a single‐arm meta‐analysis with generalized linear mixed model and Clopper‐Pearson method for confidence interval (CI) was performed to identify endoscopic, clinical and surgical recurrence rates at 6 months and 1, 2 and 5 years postoperatively. Results Altogether 24 studies were included in the meta‐analysis. The endoscopic, clinical and surgical POR rate with the use of anti‐tumor necrosis factor (TNF)‐α agents at 1 year was 21.72% (95% CI 16.28%‐28.37%), 13.06% (95% CI 8.18%‐18.92%) and 3.76% (95% CI 1.37%‐9.91%), respectively. The 5‐year recurrence rate was 84.21% (95% CI 72.35%‐91.57%) and 17.49% (95% CI 9.17%‐30.80%) for endoscopic and surgical recurrence, respectively. Subgroup analyses at 1 year for the type of anti‐TNF‐α agent or the timing of initiation after surgery showed no significant difference in endoscopic, clinical and surgical recurrence rates. Conclusions Anti‐TNF‐α agents are effective at preventing clinical, endoscopic and surgical POR of CD. The timing of initiating biological therapy after surgery has no significant effect on the rate of POR. The efficacy of infliximab and adalimumab for postoperative recurrence prevention is similar.

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Incidence of SARS‐CoV‐2 infection in inflammatory bowel disease

Cited by 8 publications

References 8 publications

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

COVID‐19 susceptibility and clinical outcomes in inflammatory bowel disease: An updated systematic review and meta‐analysis

Quantifying the rate of recurrence of postoperative Crohn's disease with biological therapy. A meta‐analysis

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