Article ; Online: Risk factors for SARS-CoV-2 infection and course of COVID-19 disease in patients with IBD in the Veterans Affair Healthcare System.
2021 Volume 70, Issue 9, Page(s) 1657–1664
Abstract: ... in the Veterans Affairs Healthcare System. We categorised IBD medication use immediately prior to the COVID-19 ... associated with an increased risk of SARS-CoV-2 infection. Except for corticosteroids no medications ... pandemic and used survival analysis methods to study associations with SARS-CoV-2 infection, as well ...
| Abstract | Objective: Our aim was to explore the risk of infection with all classes of inflammatory bowel disease (IBD) medications and the impact of these medications on the disease course in a nationwide cohort of patients with IBD. Design: This was a retrospective national cohort study of patients with IBD in the Veterans Affairs Healthcare System. We categorised IBD medication use immediately prior to the COVID-19 pandemic and used survival analysis methods to study associations with SARS-CoV-2 infection, as well as a combined secondary outcome of COVID-19 hospitalisation or COVID-19-related mortality. Results: The analytical cohort of 30 911 patients was primarily male (90.9%), white (78.6%) and with ulcerative colitis (58.8%). Over a median follow-up of 10.7 months, 649 patients (2.1%) were diagnosed with SARS-CoV-2 infection and 149 (0.5%) met the combined secondary outcome. In adjusted models, vedolizumab (VDZ) use was significantly associated with infection relative to mesalazine alone (HR 1.70, 95% CI 1.16 to 2.48, p=0.006). Patients on no IBD medications had increased risk of the combined secondary outcome relative to mesalazine alone (sub-HR 1.64, 95% CI 1.12 to 2.42, p=0.01), however, no other IBD medication categories were significantly associated with this outcome, relative to mesalazine alone (each p>0.05). Corticosteroid use was independently associated with both SARS-CoV-2 infection (HR 1.60, 95% CI 1.23 to 2.09, p=0.001) and the combined secondary outcome (sub-HR 1.90, 95% CI 1.14 to 3.17, p=0.01). Conclusion: VDZ and corticosteroid were associated with an increased risk of SARS-CoV-2 infection. Except for corticosteroids no medications including mesalazine were associated with an increased risk of severe COVID-19. |
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| MeSH term(s) | Adult ; Aged ; COVID-19/complications ; COVID-19/epidemiology ; Cohort Studies ; Female ; Humans ; Inflammatory Bowel Diseases/complications ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Risk Factors ; United States ; United States Department of Veterans Affairs |
| Language | English |
| Publishing date | 2021-03-22 |
| Publishing country | England |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 80128-8 |
| ISSN | 1468-3288 ; 0017-5749 |
| ISSN (online) | 1468-3288 |
| ISSN | 0017-5749 |
| DOI | 10.1136/gutjnl-2021-324356 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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