Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease

Tinsley, Andrew; Navabi, Seyedehsan; Williams, Emmanuelle; Liu, Guodong; Kong, Lan; Coates, Matthew; Clarke, Kofi

doi:10.1093/ibd/izy243

Cited by 124 publications

(122 citation statements)

References 24 publications

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“…Due to the modification of the immune system in IBD patients, infectious complications -both common and opportunistic -have to be considered during therapy with immunomodulators or biologics. Compared to the non-IBD population, IBD patients are at increased risk of infectious complications including influenza, pneumonia, herpes zoster, Clostridium difficile infection, CMV colitis, and others [112][113][114]. Opportunistic infections are associated with anti-TNFs, and the risk of opportunistic infection increases with age with patients over 50 years carrying a 3 times increased risk [115].…”

Section: Infectionsmentioning

confidence: 99%

Management of the Elderly Inflammatory Bowel Disease Patient

Hrúz¹,

Juillerat

Kullak-Ublick

et al. 2020

Digestion

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Section: Infectionsmentioning

confidence: 99%

Management of the Elderly Inflammatory Bowel Disease Patient

Hrúz¹,

Juillerat

Kullak-Ublick

et al. 2020

Digestion

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“…However, concern remains on the possible impact of these same immunosuppressive therapies on increasing the risk of COVID-19 or worsening its clinical course in patients on chronic treatment for immune-mediated in ammatory diseases (IMIDs) [16][17][18][19]. Due to a general impairment of the immune system, IMIDs per se are characterized by an intrinsic increased infectious risk [20][21][22]. In addition, the iatrogenic effect generated by the use of immunomodulating drugs should also be considered [23,24].…”

Section: Introductionmentioning

confidence: 99%

Impact of Corticosteroids and Immunosuppressive Therapies on Symptomatic SARS-CoV-2 Infection in a Large Cohort of Patients with Chronic Inflammatory Arthritis

Favalli

Bugatti

Klersy

et al. 2020

Preprint

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Background: Prevalence and outcomes of Coronavirus Disease (COVID)-19 in relation to immunomodulatory medications are still unknown. The aim of the study is to investigate the impact of glucocorticoids and immunosuppressive agents on COVID-19 in a large cohort of patients with chronic immune-mediated inflammatory arthritis.Methods: The study was conducted in the arthritis outpatient clinic at two large Academic Hospitals in the COVID-19 most endemic area of Northern Italy (Lombardy). We circulated a cross-sectional survey exploring the prevalence of Severe Acute Respiratory Syndrome-Coronavirus-2 nasopharyngeal swab positivity and the occurrence of acute respiratory illness (fever and/or cough and/or dyspnea), administered face-to-face or by phone to consecutive patients from 25th February to 20th April 2020. COVID-19 cases were defined as confirmed or highly suspicious according to the World Health Organization criteria. The impact of medications on COVID-19 incidence was evaluated. Results: The study population included 2050 adults with chronic inflammatory arthritis receiving glucocorticoids, conventional-synthetic (cs), or targeted-synthetic/biological (ts/b) disease-modifying drugs (DMARDs). Laboratory-confirmed COVID-19 and highly suspicious infection were recorded in 1.1% and 1.4% of the population, respectively. Treatment with glucocorticoids was independently associated with increased risk of COVID-19 (adjusted OR [95% CI] ranging from 1.23 [1.04-1.44] to 3.20 [1.97-5.18] depending on the definition used). Conversely, patients treated with ts/bDMARDs were at reduced risk (adjusted OR ranging from 0.46 [0.18-1.21] to 0.47 [0.46-0.48]). No independent effects of csDMARDs were observed.Conclusions: During the COVID-19 outbreak, treatment with immunomodulatory medications appears safe. Conversely, glucocorticoids, even at low-dose, may confer increased risk of infection.Trial registration: retrospectively registered

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“…So ist ein erhöhtes Risiko für Patienten mit CED, an Influenza zu erkranken bzw. aus diesem Grund hospitalisiert zu werden, beschrieben [31]. Weiterhin beschreiben Ko und Mitarbeiter für CED-Patienten im ersten Krankheitsjahr eine Hospitalisierung aufgrund von Infektionen bei 7,9 %; dabei ist mehr als 1/3 durch Infektionen des Respirationstrakts bedingt [32].…”

Section: Empfehlungunclassified

Addendum zu den S3-Leitlinien Morbus Crohn und Colitis ulcerosa: Betreuung von Patienten mit chronisch entzündlichen Darmerkrankungen in der COVID-19-Pandemie – offene Fragen und Antworten

et al. 2020

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ZusammenfassungDie COVID-19-Pandemie ist ein weltweiter Ausbruch von neu aufgetretenen Infektionen mit dem SARS-CoV-2-Virus, von denen weltweit derzeit mehr als 10.670.000 Menschen erkrankt sind bzw. waren. In Deutschland leiden ca. 450.000 Patienten an einer chronisch entzündlichen Darmerkrankung; diese Patienten benötigen in der Regel eine kontinuierliche und kompetente Betreuung. Vor dem Hintergrund eines rasch zunehmenden Wissenszuwachses haben 68 Experten, die die derzeit gültigen Leitlinien der DGVS zum Morbus Crohn und zur Colitis ulcerosa erstellt haben, im Rahmen einer virtuellen Konferenz aktuelle und praxisnahe Empfehlungen formuliert, um die Versorgung von CED-Patienten zu verbessern. Diese adressieren das Infektionsrisiko einschließlich des Risikos für besondere Gruppen, den möglichen Verlauf der Erkrankung und die Konsequenzen für die medikamentöse und die operative Therapie der Grunderkrankung sowie allgemeine Maßnahmen zur Infektionsprävention und adjuvante Präventions- und Therapiemöglichkeiten.

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Increased Risk of Influenza and Influenza-Related Complications Among 140,480 Patients With Inflammatory Bowel Disease

Abstract: Inflammatory bowel disease patients had an increased risk of influenza compared with those without IBD and were more likely to require hospitalization. Steroids were the only medication class independently associated with flu risk.

Cited by 124 publications

References 24 publications

Management of the Elderly Inflammatory Bowel Disease Patient

Management of the Elderly Inflammatory Bowel Disease Patient

Impact of Corticosteroids and Immunosuppressive Therapies on Symptomatic SARS-CoV-2 Infection in a Large Cohort of Patients with Chronic Inflammatory Arthritis

Addendum zu den S3-Leitlinien Morbus Crohn und Colitis ulcerosa: Betreuung von Patienten mit chronisch entzündlichen Darmerkrankungen in der COVID-19-Pandemie – offene Fragen und Antworten

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