Interim analysis of a multicenter registry study of COVID-19 patients with inflammatory bowel disease in Japan (J-COSMOS)

Abstract

Background The spread of coronavirus disease 2019 (COVID-19) had a major impact on the health of people worldwide. The clinical background and clinical course of inflammatory bowel disease (IBD) among Japanese patients with COVID-19 remains unclear. Methods This study is an observational cohort of Japanese IBD patients diagnosed with COVID-19. Data on age, sex, IBD (classification, treatment, and activity), COVID-19 symptoms and severity, and treatment of COVID-19 were analyzed. Results From 72 participating facilities in Japan, 187 patients were registered from June 2020 to October 2021. The estimated incidence of COVID19 in Japanese IBD patients was 0.61%. The majority of IBD patients with COVID-19 (73%) were in clinical remission. According to the WHO classification regarding COVID-19 severity, 93% (172/184) of IBD patients had non-severe episodes, while 7% (12/184) were severe cases including serious conditions. 90.9% (165/187) of IBD patients with COVID-19 had no change in IBD disease activity. A logistic regression analysis stepwise method revealed that older age, higher body mass index (BMI), and steroid use were independent risk factors for COVID-19 severity. Six of nine patients who had COVID-19 after vaccination were receiving anti-tumor necrosis factor (TNF)-α antibodies. Conclusion Age, BMI and steroid use were associated with COVID-19 severity in Japanese IBD patients.

SARS-CoV-2 Vaccination Response in Japanese Patients with Autoimmune Hepatitis: Results of Propensity Score-Matched Case–Control Study

“…Patients with AIH are generally ubiquitous among middle-aged and older women, and the continuation of immunomodulating agents such as adrenal steroids and thiopurines is essential for disease control [ 20 , 21 ]. In older patients and patients with immunosuppressants, relatively low anti-SARS-CoV-2 spike antibody concentrations have already been reported in other diseases [ 8 , 22 ], and the results of this study were also consistent with these reports.…”

“…WHO, in its press conference at the time of declaring the emergency over, also stated that the actual number of deaths due to COVID-19 was at least 20 million [ 7 ], and that continued vaccination, particularly for those with the disease, is strongly recommended in the future. In fact, the mortality rate from COVID-19 infection in elderly patients is significantly higher than in non-elderly populations, and patients who are continuously taking immunosuppressive drugs such as steroids have a higher rate of severe disease when infected with COVID-19 [ 8 ]. Compounding these aforementioned facts, patients with autoimmune hepatitis in Japan seem to be particularly threatened by the risk of severe disease due to COVID-19 infection.…”

An older patient with active ulcerative colitis and coronavirus disease 2019 (COVID-19) pneumonia successfully treated with the combination of anti-TNFα therapy and azathioprine

“…Patients with IBD are treated with 5-ASA, corticosteroids, thiopurines, and molecular-targeting agents, depending on the extent and severity of the disease [ 9 ]. Therefore, both physicians and patients with IBD are concerned about developing COVID-19 in IBD patients while on immunomodulatory therapy.…”

The impact of the COVID‐19 pandemic on hepatocellular carcinoma diagnosis and treatment in Japan: A multicenter collaborative observational study

“…1 Patients with underlying medical conditions are more likely to develop severe symptoms of COVID-19. [2][3][4][5] Patients with liver cirrhosis or hepatocellular carcinoma (HCC) are no exception. 2,[6][7][8][9][10] At the outset of the COVID-19 pandemic, patients may have been reluctant to visit hospitals for fear of SARS-CoV-2 infection.…”

“…It emerged in December 2019 and spread rapidly worldwide 1 . Patients with underlying medical conditions are more likely to develop severe symptoms of COVID‐19 2–5 . Patients with liver cirrhosis or hepatocellular carcinoma (HCC) are no exception 2,6–10 …”