Allegheny Health Network Pittsburgh, PA, United States
Yousaf Hadi, MD1, Parambir Dulai, MD2, Justin Kupec, MD, FACG1, Nabeeha Mohy-Ud-Din, MD3, Vipul Jairath, MD4, Francis A. Farraye, MD, MSc5, Gursimran S. Kochhar, MD3 1West Virginia University, Morgantown, WV; 2University of California San Diego, San Diego, CA; 3Allegheny Health Network, Pittsburgh, PA; 4Western University London, London, ON, Canada; 5Mayo Clinic, Jacksonville, FL
Introduction: Several studies have examined outcomes of COVID-19 in patients with IBD however these reports have inherent limitations including a lack of matched controls precluding accurate assessment of risk, and lack of follow up data to assess for IBD flares and risk of de novo IBD in COVID-19 affected populations.
Methods: We performed a retrospective cohort study using a multi-institutional research network TriNETX. Patients with IBD >16 yrs of age with COVID-19 (up to Feb 7, 2021) were matched 1:1 with non-IBD COVID-19 patients based on demographic variables and known risk factors for severe COVID-19 infection. Outcomes of COVID-19 disease in IBD were compared to the matched control cohort, and outcomes in IBD subpopulations were explored. The incidence of COVID-19 disease in patients with IBD was compared to the general population, and the relationship of incident cases of IBD with prior COVID-19 disease was investigated.
Results: A total of 628,947 patients with COVID-19 met inclusion criteria (3486 in IBD and 625,461 in the non- IBD cohort). Prevalence of COVID-19 in patients with IBD cohort was 5.95%. Patients with IBD had a lower incidence of COVID-19 compared to the general population; IRR: 0.79 (95% CI: 0.72-0.86). The IBD cohort had a higher rate of inpatient treatment with no difference in mortality, mechanical ventilation or AKI noted in the propensity-matched analysis. Patients with IBD corticosteroids at baseline were found to be at increased risk for mortality (RR: 2.08, 95% CI:1.06-4.10, hospitalization and 30-day composite outcome (hospitalization or mortality). No difference in composite outcome was noted in the 5-ASA, biologic agent, and anti-TNF group compared to non-IBD cohort. 210 patients (6.0%) and 243 patients (7.0%) developed an IBD flare in 1 month and 3 months after COVID-19 diagnosis respectively. A total of 774 patients (0.10%) with no prior history of IBD were diagnosed with de novo IBD after COVID-19 infection. The IBD diagnosis rate after COVID-19 was lower compared to a control group of patients who were never diagnosed with COVID-19, on propensity score-matched analysis (RR 0.59; 95% CI:0.54-0.65).
Discussion: In a large cohort of patients with IBD infected with COVID-19, we found a higher rate of in-patient treatment without differences in other clinical outcomes compared to a matched cohort of patients without IBD. The rate of de novo IBD after COVID-19 and disease exacerbations in cases of prior IBD was low, and no IBD therapy was linked to worse outcomes.
Yousaf Hadi indicated no relevant financial relationships.
Parambir Dulai indicated no relevant financial relationships.
Justin Kupec indicated no relevant financial relationships.
Nabeeha Mohy-Ud-Din indicated no relevant financial relationships.
Francis Farraye indicated no relevant financial relationships.
Gursimran Kochhar: Corrona foundation – Advisory Committee/Board Member.
Yousaf Hadi, MD1, Parambir Dulai, MD2, Justin Kupec, MD, FACG1, Nabeeha Mohy-Ud-Din, MD3, Vipul Jairath, MD4, Francis A. Farraye, MD, MSc5, Gursimran S. Kochhar, MD3. P1603 - Incidence, Outcomes, and Impact of COVID-19 on Inflammatory Bowel Disease: Propensity Matched Analysis of a Large Research Network, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.