Presence of Comorbidities Associated with Severe Coronavirus Infection in Patients with Inflammatory Bowel Disease

Abstract

Background Comorbidities increase the risk of coronavirus disease 2019 (COVID-19) hospitalization and mortality. As many comorbidities are common in patients with inflammatory bowel diseases (IBD), we sought to investigate the effects of comorbidities in these patients on infection severity. Aim To evaluate association between individual comorbidities and COVID-19 infection severity among patients with IBD. Methods Data were obtained from SECURE-IBD, an international registry created to evaluate COVID-19 outcomes in patients with IBD. We used multivariable regression to analyze associations between eleven non-IBD comorbidities and a composite primary outcome of COVID-19-related hospitalization or death. Comorbidities were first modeled individually, adjusting for potential confounders. Next, to determine the independent effect of comorbidities, we fit a model including all comorbidities as covariates. Results We analyzed 2,035 patients from 58 countries (mean age 42.7 years, 50.6% male). A total of 538 patients (26.4%) experienced severe COVID-19. All comorbidities but a history of stroke and obesity were associated with severe infection in our initial analysis, with adjusted odds ratios ranging from 1.9 to 3.7. In a model including all comorbidities significantly associated with the composite outcome in the initial analysis, as well as other confounders, most comorbidities remained significant, with the highest risk in chronic kidney disease and chronic obstructive pulmonary disease. Conclusion Many non-IBD comorbidities are associated with a two to threefold increased risk of COVID-19 hospitalization or death among patients with IBD. These data can be used to risk-stratify and guide treatment and lifestyle decisions during the ongoing pandemic.

High Mortality During the Second Wave of the Coronavirus Disease 2019 (COVID-19) Pandemic in Uganda: Experience From a National Referral COVID-19 Treatment Unit

“…Approximately half of our study participants had at least 1 comorbidity, especially hypertension and diabetes mellitus. These underlying diseases are common in patients with COVID-19 [ 5 , 8 , 29 ] and are independently associated with severe disease and mortality [ 8 ]. From our analysis, hypertension and having any comorbidity were associated with mortality at bivariate analysis.…”

“…The majority of people infected with SARS-CoV-2 are asymptomatic [ 3 , 4 ]. However, 15% to 20% of symptomatic patients present with severe illness, manifesting as the need for hospitalization, supplemental oxygenation, mechanical ventilation, and eventually death [ 5 , 6 ]. Although severe COVID-19 can occur in otherwise healthy individuals of any age, the risk of severe illness is more marked in adults with advanced age or underlying medical comorbidities, including diabetes mellitus, obesity, malignancies, and hypertension [ 7–9 ].…”

Survival analysis of patients with COVID-19 admitted at six hospitals in Uganda in 2021: a cohort study

“…The clinical presentations of COVID-19 range from an asymptomatic infection, mild disease to severe illness and death [5]. Majority of the patients have asymptomatic to mild COVID-19 disease and about 15% of the COVID-19 patients suffered severe illness which presented as need for hospitalization, supplemental oxygen or mechanical ventilation [6,7]. A number of studies conducted in mostly high income countries have revealed that the factors associated with severe COVID-19 illness and mortality are older age, male gender, and having comorbidities such as hypertension, diabetes, cardiovascular diseases and respiratory diseases [8][9][10][11][12][13][14][15][16][17][18][19][20][21].…”

Letter: paying attention to the comorbidities or extraintestinal complications in patients with inflammatory bowel disease during the COVID‐19 pandemic

“…4 In addition, studies have shown that the presence of chronic liver diseases, such as the metabolic dysfunctionassociated fatty liver disease or non-alcoholic fatty liver disease, was associated with a more severe COVID-19. 5,6 Although Hadi Y et al…”

“… 4 In addition, studies have shown that the presence of chronic liver diseases, such as the metabolic dysfunction‐associated fatty liver disease or non‐alcoholic fatty liver disease, was associated with a more severe COVID‐19. 5 , 6 Although Hadi Y et al statistically controlled the effects of body mass index, autoimmune/inflammatory arthropathies, type 1 diabetes, coeliac disease, autoimmune thyroid disease and a composite of autoimmune skin diseases by covariance analysis, they did not mention these extraintestinal manifestations or comorbidities as confounders. 1 Therefore, it is necessary to exclude confounding factors or avoid incomplete medical records.…”