SARS-CoV-2 infection in patients with inflammatory bowel disease: comparison between the first and second pandemic waves

Abstract

Background In Italy, the incidence of SARS-CoV-2 infection peaked in April and November 2020, defining two pandemic waves of coronavirus disease 2019 (COVID-19). This study compared the characteristics and outcomes of patients with inflammatory bowel disease (IBD) and SARS-CoV-2 infections between pandemic waves. Methods Observational longitudinal study of IBD patients with SARS-CoV-2 infection. Patients with established diagnoses of IBD and of SARS-CoV-2 infection were consecutively enrolled in two periods: (i) first wave, from 1 March 2020 to 31 May 2020; and (ii) second wave, from 15 September to 15 December 2020. Results We enrolled 937 IBD patients (219 in the first wave, 718 in the second wave). Patients of the first wave were older (mean ± SD: 46.3 ± 16.2 vs. 44.1 ± 15.4 years, p = 0.06), more likely to have ulcerative colitis (58.0% vs. 44.4%, p < 0.001) and comorbidities (48.9% vs. 38.9%; p < 0.01), and more frequently residing in Northern Italy (73.1% vs. 46.0%, p < 0.001) than patients of the second wave. There were no significant differences between pandemic waves in sex (male: 54.3% vs. 53.3%, p = 0.82) or frequency of active IBD (44.3% vs. 39.0%, p = 0.18). The rates of negative outcomes were significantly higher in the first than second wave: pneumonia (27.8% vs. 11.7%, p < 0.001), hospital admission (27.4% vs. 9.7%, p < 0.001), ventilatory support (11.9% vs. 5.4%, p < 0.003) and death (5.5% vs. 1.8%, p < 0.007). Conclusion Between the first and second SARS-CoV-2 pandemic waves, demographic, clinical and geographical features of IBD patients were different as were the symptoms and outcomes of infection. These differences are likely due to the different epidemiological situations and diagnostic possibilities between the two waves.

Exploring the Impact of COVID-19 on Ulcerative Colitis Patients: A Lifestyle Perspective

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in China at the end of 2019, is a beta coronavirus that is transmitted by airway droplets from human to human [1] and that caused the coronavirus disease 2019 (COVID- 19) outbreak [2,3]. SARS-CoV-2 expresses surface spike proteins that bind to various receptors of human cells (CD26, CD147, and CD209), with the type 2 angiotensin-converting enzyme (ACE2) as the main target.…”

“…Data on the association between COVID-19 and ulcerative colitis (UC) are limited. The risk factors for a more severe COVID-19 disease in patients with inflammatory bowel disease (IBD) are an active disease and UC-a chronic, idiopathic, immune-mediated inflammatory disorder of the digestive tract [2]. In general, IBD affects nearly 3 million people in the United States and 2.5-3 million people in Europe, with a direct healthcare cost of EUR 4.6-5.6 billion annually in Europe, mostly due to hospitalisations and surgeries [6,7].…”