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Feng J, Chen J, Li X, Ren X, Chen J, Li Z, Wu Y, Zhang Z, Yang R, Li J, Lu Y, Liu Y. Mendelian randomization and Bayesian model averaging of autoimmune diseases and Long COVID. Front Genet 2024; 15:1383162. [PMID: 39005628 PMCID: PMC11240141 DOI: 10.3389/fgene.2024.1383162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/27/2024] [Indexed: 07/16/2024] Open
Abstract
Background Following COVID-19, reports suggest Long COVID and autoimmune diseases (AIDs) in infected individuals. However, bidirectional causal effects between Long COVID and AIDs, which may help to prevent diseases, have not been fully investigated. Methods Summary-level data from genome-wide association studies (GWAS) of Long COVID (N = 52615) and AIDs including inflammatory bowel disease (IBD) (N = 377277), Crohn's disease (CD) (N = 361508), ulcerative colitis (UC) (N = 376564), etc. were employed. Bidirectional causal effects were gauged between AIDs and Long COVID by exploiting Mendelian randomization (MR) and Bayesian model averaging (BMA). Results The evidence of causal effects of IBD (OR = 1.06, 95% CI = 1.00-1.11, p = 3.13E-02), CD (OR = 1.10, 95% CI = 1.01-1.19, p = 2.21E-02) and UC (OR = 1.08, 95% CI = 1.03-1.13, p = 2.35E-03) on Long COVID was found. In MR-BMA, UC was estimated as the highest-ranked causal factor (MIP = 0.488, MACE = 0.035), followed by IBD and CD. Conclusion This MR study found that IBD, CD and UC had causal effects on Long COVID, which suggests a necessity to screen high-risk populations.
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Affiliation(s)
- Jieni Feng
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiankun Chen
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Emerging Infectious Diseases, Guangzhou, China
| | - Xiaoya Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaolei Ren
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junxu Chen
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zuming Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuan Wu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhongde Zhang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rongyuan Yang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Emerging Infectious Diseases, Guangzhou, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiqiang Li
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Emerging Infectious Diseases, Guangzhou, China
| | - Yue Lu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuntao Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- The Second Affiliated Hospital (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangzhou Key Laboratory of Traditional Chinese Medicine for Prevention and Treatment of Emerging Infectious Diseases, Guangzhou, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Leston M, Elson W, Ordóñez-Mena JM, Kar D, Whitaker H, Joy M, Roberts N, Hobbs FDR, de Lusignan S. Disparities in COVID-19 mortality amongst the immunosuppressed: A systematic review and meta-analysis for enhanced disease surveillance. J Infect 2024; 88:106110. [PMID: 38302061 PMCID: PMC10943183 DOI: 10.1016/j.jinf.2024.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Effective disease surveillance, including that for COVID-19, is compromised without a standardised method for categorising the immunosuppressed as a clinical risk group. METHODS We conducted a systematic review and meta-analysis to evaluate whether excess COVID-associated mortality compared to the immunocompetent could meaningfully subdivide the immunosuppressed. Our study adhered to UK Immunisation against infectious disease (Green Book) criteria for defining and categorising immunosuppression. Using OVID (EMBASE, MEDLINE, Transplant Library, and Global Health), PubMed, and Google Scholar, we examined relevant literature between the entirety of 2020 and 2022. We selected for cohort studies that provided mortality data for immunosuppressed subgroups and immunocompetent comparators. Meta-analyses, grey literature and any original works that failed to provide comparator data or reported all-cause or paediatric outcomes were excluded. Odds Ratios (OR) and 95% confidence intervals (CI) of COVID-19 mortality were meta-analysed by immunosuppressed category and subcategory. Subgroup analyses differentiated estimates by effect measure, country income, study setting, level of adjustment, use of matching and publication year. Study screening, extraction and bias assessment were performed blinded and independently by two researchers; conflicts were resolved with the oversight of a third researcher. PROSPERO registration number is CRD42022360755. FINDINGS We identified 99 unique studies, incorporating data from 1,542,097 and 56,248,181 unique immunosuppressed and immunocompetent patients with COVID-19 infection, respectively. Compared to immunocompetent people (pooled OR, 95%CI), solid organ transplants (2.12, 1.50-2.99) and malignancy (2.02, 1.69-2.42) patients had a very high risk of COVID-19 mortality. Patients with rheumatological conditions (1.28, 1.13-1.45) and HIV (1.20, 1.05-1.36) had just slightly higher risks than the immunocompetent baseline. Case type, setting income and mortality data matching and adjustment were significant modifiers of excess immunosuppressed mortality for some immunosuppressed subgroups. INTERPRETATION Excess COVID-associated mortality among the immunosuppressed compared to the immunocompetent was seen to vary significantly across subgroups. This novel means of subdivision has prospective benefit for targeting patient triage, shielding and vaccination policies during periods of high disease transmission.
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Affiliation(s)
- Meredith Leston
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom.
| | - Willam Elson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Jose M Ordóñez-Mena
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Debasish Kar
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Heather Whitaker
- Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, 61 Colindale Avenue, London NW9 5EQ, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Old Campus Road, Old Campus Research Building, Headington, Oxford OX3 7DQ, United Kingdom
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, United Kingdom
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Ismail NF, Rahman AE, Kulkarni D, Zhu F, Wang X, del Carmen Morales G, Srivastava A, Allen KE, Spinardi J, Kyaw MH, Nair H. Incidence and outcome of SARS-CoV-2 reinfection in the pre-Omicron era: A global systematic review and meta-analysis. J Glob Health 2023; 13:06051. [PMID: 37994839 PMCID: PMC10667793 DOI: 10.7189/jogh.13.06051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
Background With the emergence of new variants and sub-lineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reinfections can significantly impact herd immunity, vaccination policies, and decisions on other public health measures. We conducted a systematic review and meta-analysis to synthesise the global evidence on SARS-CoV-2 reinfections in the pre-Omicron era. Methods We searched five global databases (MEDLINE, Embase, CINAHL Plus, Global Health, WHO COVID-19) on 12 May 2022 and 28 July 2023 and three Chinese databases (CNKI, Wanfang, CQvip) on 16 October 2022 for articles reporting incidence and outcomes of SARS-CoV-2 reinfection before the period of Omicron (B.1.1.529) predominance. We assessed risk of bias using Joanna Briggs Institute critical appraisal tools and conducted meta-analyses with random effects models to estimate the proportion of SARS-CoV-2 reinfection among initially infected cases and hospitalisation and mortality proportions among reinfected ones. Results We identified 7593 studies and extracted data from 64 included ones representing 21 countries. The proportion of SARS-CoV-2 reinfection was 1.16% (95% confidence interval (CI) = 1.01-1.33) based on 11 639 247 initially infected cases, with ≥45 days between the two infections. Healthcare providers (2.28%; 95% CI = 1.37-3.40) had a significantly higher risk of reinfection than the general population (1.00%; 95% CI = 0.81-1.20), while young adults aged 18 to 35 years (1.01%; 95% CI = 0.8-1.25) had a higher reinfection burden than other age groups (children <18 years old: 0.57%; 95% CI = 0.39-0.79, older adults aged 36-65 years old: 0.53%; 95% CI = 0.41-0.65, elderly >65 years old: 0.37%; 95% CI = 0.15-0.66). Among the reinfected cases, 8.12% (95% CI = 5.30-11.39) were hospitalised, 1.31% (95% CI = 0.29-2.83) were admitted to the intensive care unit, and 0.71% (95% CI = 0.02-2.01) died. Conclusions Our data suggest a relatively low risk of SARS-CoV-2 reinfection in the pre-Omicron era, but the risk of hospitalisation was relatively high among the reinfected cases. Considering the possibility of underdiagnosis, the reinfection burden may be underestimated. Registration PROSPERO: CRD42023449712.
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Affiliation(s)
- Nabihah Farhana Ismail
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- Communicable Disease Control Unit, Public Health Department, Johor State, Malaysia
| | - Ahmed Ehsanur Rahman
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- International Centre for Diarrhoeal Diseases Research, Bangladesh
| | - Durga Kulkarni
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Fuyu Zhu
- School of Public Health, Nanjing Medical University, Jiangsu, China
| | - Xin Wang
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Jiangsu, China
| | | | - Amit Srivastava
- Pfizer, Vaccines, Emerging Markets
- Orbital Therapeutics, United States of America
| | | | | | | | - Harish Nair
- Centre for Global Health, University of Edinburgh, Edinburgh, United Kingdom
- School of Public Health, Nanjing Medical University, Jiangsu, China
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Nørgård BM, Zegers FD, Nielsen J, Knudsen T, Kjeldsen J. COVID-19 Does Not Lead to an Increase in Corticosteroid Prescriptions in IBD Patients: A Nationwide Cohort Study. Inflamm Bowel Dis 2023; 29:1470-1476. [PMID: 37067508 DOI: 10.1093/ibd/izad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND It is not known whether coronavirus 2019 (COVID-19) is a trigger for disease activity in patients with inflammatory bowel diseases (IBD). In patients with IBD, we aimed to examine the association between COVID-19 infection and prescriptions of systemic and local corticosteroids (used as proxy for disease activity). METHODS This nationwide cohort study was based on Danish health registries and included all patients in Denmark with ulcerative colitis (UC) or Crohn's disease (CD) by the start of the pandemic (March 1, 2020) and who had a positive COVID-19 polymerase chain reaction (PCR) test from March 1, 2020, to July 31, 2022. We calculated rates of corticosteroid prescriptions 6 months before and 6 months after a positive COVID-19 PCR test, and we calculated adjusted incidence rate ratios (aIRR). RESULTS We included 30,102 patients with IBD and a positive COVID-19 test (11,159 with CD, 18,493 with UC). The aIRR for having corticosteroid prescriptions after a COVID-19 positive test was 0.85 (95% confidence interval [CI], 0.79-0.91). When we stratified for underlying disease, the aIRR for having corticosteroid after a COVID-19 positive test in UC was 0.82 (95% CI, 0.75-0.90), and in CD 0.91 (95% CI, 0.81-1.02). Stratifications according to calendar periods and age groups showed consistent results. CONCLUSIONS An infection with COVID-19 did not result in a higher rate of filled corticosteroid prescriptions. Using corticosteroids as a proxy for disease activity, COVID-19 did not seem to trigger disease activity, which is a reassuring result for patients with IBD.
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Affiliation(s)
- Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense C, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Floor Dijkstra Zegers
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense C, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Jan Nielsen
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense C, Denmark
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Torben Knudsen
- Department of Medical Gastroenterology, Hospital of Southwest Jutland, Esbjerg, Denmark
- Department of Regional Health Science, University of Southern Denmark, Esbjerg, Denmark
| | - Jens Kjeldsen
- Department of Medical Gastroenterology S, Odense University Hospital, 5000 Odense C, Denmark
- Research Unit of Medical Gastroenterology, Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark
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5
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Bourgonje AR, Otten AT. The Risk of Developing Long COVID in Patients With Inflammatory Bowel Diseases: Do Immunosuppressive Drugs Matter? Clin Gastroenterol Hepatol 2023; 21:1971-1972. [PMID: 36642294 DOI: 10.1016/j.cgh.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Arno R Bourgonje
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Antonius T Otten
- Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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6
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Khan N, Mahmud N. Reply. Clin Gastroenterol Hepatol 2023; 21:1972-1973. [PMID: 36806627 PMCID: PMC10426455 DOI: 10.1016/j.cgh.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/23/2023]
Affiliation(s)
- Nabeel Khan
- Department of Gastroenterology, Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania; Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Nadim Mahmud
- Department of Gastroenterology, Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania; Division of Gastroenterology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
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7
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Wang F, Xie J, Xiong H, Xie Y. A bibliometric analysis of inflammatory bowel disease and COVID-19 researches. Front Public Health 2023; 11:1039782. [PMID: 36794064 PMCID: PMC9922853 DOI: 10.3389/fpubh.2023.1039782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Background Patients with inflammatory bowel disease (IBD) often require immunosuppressive therapy and are hence susceptible to various opportunistic viral and bacterial infections. In this regard, many studies on IBD and COVID-19 have been conducted. However, no bibliometric analysis has been performed. This study provides a general overview of IBD and COVID-19. Methods Publications about IBD and COVID-19 from 2020 to 2022 were retrieved from the Web of Science Core Collection (WoSCC) database. Bibliometric analysis was performed using VOSviewer, CiteSpace, and HistCite. Results A total of 396 publications were retrieved and considered in this study. The maximum number of publications were from the United States, Italy, and England, and the contributions of these countries were significant. Kappelman ranked first in article citations. The Icahn School of Medicine at Mount Sinai and Inflammatory Bowel Diseases were the most prolific affiliation and journal, respectively. The most influential research topics were "management", "impact", "vaccination", and "receptor". The following keywords represented research frontiers: "depression", "the quality of life of IBD patients", "infliximab", "COVID-19 vaccine", and "second vaccination". Conclusions Over the past 3 years, most studies on IBD and COVID-19 have focused on clinical research. In particular, topics such as "depression", "the quality of life of IBD patients", "infliximab", "COVID-19 vaccine", and "second vaccination" were noted to have received much attention recently. Future research should focus on our understanding of the immune response to COVID-19 vaccination in biologically treated patients, the psychological impact of COVID-19, IBD management guidelines, and the long-term impact of COVID-19 in IBD patients. This study will provide researchers with a better understanding of research trends on IBD during COVID-19.
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Affiliation(s)
- Fangfei Wang
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,Gastroenterology Institute of Jiangxi Province, Nanchang, Jiangxi, China,Key Laboratory of Digestive Diseases of Jiangxi Province, Nanchang, Jiangxi, China,Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China,Digestive Disease Hospital, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jinliang Xie
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,Gastroenterology Institute of Jiangxi Province, Nanchang, Jiangxi, China,Key Laboratory of Digestive Diseases of Jiangxi Province, Nanchang, Jiangxi, China,Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China,Digestive Disease Hospital, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Huifang Xiong
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,Gastroenterology Institute of Jiangxi Province, Nanchang, Jiangxi, China,Key Laboratory of Digestive Diseases of Jiangxi Province, Nanchang, Jiangxi, China,Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China,Digestive Disease Hospital, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yong Xie
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,Gastroenterology Institute of Jiangxi Province, Nanchang, Jiangxi, China,Key Laboratory of Digestive Diseases of Jiangxi Province, Nanchang, Jiangxi, China,Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi, China,Digestive Disease Hospital, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China,*Correspondence: Yong Xie ✉
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8
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Du M, Ma Y, Deng J, Liu M, Liu J. Comparison of Long COVID-19 Caused by Different SARS-CoV-2 Strains: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316010. [PMID: 36498103 PMCID: PMC9736973 DOI: 10.3390/ijerph192316010] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 06/01/2023]
Abstract
Although many studies of long COVID-19 were reported, there was a lack of systematic research which assessed the differences of long COVID-19 in regard to what unique SARS-CoV-2 strains caused it. As such, this systematic review and meta-analysis aims to evaluate the characteristics of long COVID-19 that is caused by different SARS-CoV-2 strains. We systematically searched the PubMed, EMBASE, and ScienceDirect databases in order to find cohort studies of long COVID-19 as defined by the WHO (Geneva, Switzerland). The main outcomes were in determining the percentages of long COVID-19 among patients who were infected with different SARS-CoV-2 strains. Further, this study was registered in PROSPERO (CRD42022339964). A total of 51 studies with 33,573 patients was included, of which three studies possessed the Alpha and Delta variants, and five studies possessed the Omicron variant. The highest pooled estimate of long COVID-19 was found in the CT abnormalities (60.5%; 95% CI: 40.4%, 80.6%) for the wild-type strain; fatigue (66.1%; 95% CI: 42.2%, 89.9%) for the Alpha variant; and ≥1 general symptoms (28.4%; 95% CI: 7.9%, 49.0%) for the Omicron variant. The pooled estimates of ≥1 general symptoms (65.8%; 95% CI: 47.7%, 83.9%) and fatigue were the highest symptoms found among patients infected with the Alpha variant, followed by the wild-type strain, and then the Omicron variant. The pooled estimate of myalgia was highest among patients infected with the Omicron variant (11.7%; 95%: 8.3%, 15.1%), compared with those infected with the wild-type strain (9.4%; 95%: 6.3%, 12.5%). The pooled estimate of sleep difficulty was lowest among the patients infected with the Delta variant (2.5%; 95%: 0.2%, 4.9%) when compared with those infected with the wild-type strain (24.5%; 95%: 17.5%, 31.5%) and the Omicron variant (18.7%; 95%: 1.0%, 36.5%). The findings of this study suggest that there is no significant difference between long COVID-19 that has been caused by different strains, except in certain general symptoms (i.e., in the Alpha or Omicron variant) and in sleep difficulty (i.e., the wild-type strain). In the context of the ongoing COVID-19 pandemic and its emerging variants, directing more attention to long COVID-19 that is caused by unique strains, as well as implementing targeted intervention measures to address it are vital.
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Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Yirui Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jie Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
- Institute for Global Health and Development, Peking University, No. 5, Yiheyuan Road, Haidian District, Beijing 100871, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People’s Republic of China, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China
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9
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Hong SJ, Bhattacharya S, Aboubakr A, Nadkarni D, Lech D, Ungaro RC, Agrawal M, Hirten RP, Greywoode R, Mone A, Chang S, Hudesman DP, Ullman T, Sultan K, Lukin DJ, Colombel JF, Axelrad JE. COVID-19 is not associated with worse long-term inflammatory bowel disease outcomes: a multicenter case-control study. Therap Adv Gastroenterol 2022; 15:17562848221132363. [PMID: 36348637 PMCID: PMC9637830 DOI: 10.1177/17562848221132363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is not associated with worse coronavirus disease 2019 (COVID-19) outcomes. However, data are lacking regarding the long-term impact of severe acute respiratory syndrome coronavirus 2 infection on the disease course of IBD. OBJECTIVES We aimed to investigate the effect of COVID-19 on long-term outcomes of IBD. DESIGN We performed a multicenter case-control study of patients with IBD and COVID-19 between February 2020 and December 2020. METHODS Cases and controls were individuals with IBD with presence or absence, respectively, of COVID-19-related symptoms and confirmatory testing. The primary composite outcome was IBD-related hospitalization or surgery. RESULTS We identified 251 cases [ulcerative colitis (n = 111, 45%), Crohn's disease (n = 139, 55%)] and 251 controls, with a median follow-up of 394 days. The primary composite outcome of IBD-related hospitalization or surgery occurred in 29 (12%) cases versus 38 (15%) controls (p = 0.24) and on multivariate Cox regression, COVID-19 was not associated with increased risk of adverse IBD outcomes [adjusted hazard ratio (aHR): 0.84, 95% confidence interval [CI]: 0.44-1.42]. When stratified by infection severity, severe COVID-19 was associated with a numerically increased risk of adverse IBD outcomes (aHR: 2.43, 95% CI: 1.00-5.86), whereas mild-to-moderate COVID-19 was not (aHR: 0.68, 95% CI: 0.38-1.23). CONCLUSION In this case-control study, COVID-19 did not have a long-term impact on the disease course of IBD. However, severe COVID-19 was numerically associated with worse IBD outcomes, underscoring the continued importance of risk mitigation and prevention strategies for patients with IBD during the ongoing COVID-19 pandemic.
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Affiliation(s)
| | - Sumona Bhattacharya
- Inflammatory Bowel Disease Center, Division of
Gastroenterology, NYU Langone Health, New York, NY, USA
| | - Aiya Aboubakr
- Jill Roberts Center for Inflammatory Bowel
Disease, Division of Gastroenterology and Hepatology, Department of
Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Devika Nadkarni
- The Dr. Henry D. Janowitz Division of
Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Diana Lech
- Division of Gastroenterology, Northwell Health,
North Shore University Hospital and Long Island Jewish Medical Center, Great
Neck, NY, USA
| | - Ryan C. Ungaro
- The Dr. Henry D. Janowitz Division of
Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Manasi Agrawal
- The Dr. Henry D. Janowitz Division of
Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Robert P. Hirten
- The Dr. Henry D. Janowitz Division of
Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Ruby Greywoode
- Division of Gastroenterology, Montefiore
Medical Center, Bronx, NY, USA
| | - Anjali Mone
- Division of Gastroenterology, Northwell
Health, North Shore University Hospital and Long Island Jewish Medical
Center, Great Neck, NY, USA
| | - Shannon Chang
- Inflammatory Bowel Disease Center, Division of
Gastroenterology, NYU Langone Health, New York, NY, USA
| | - David P. Hudesman
- Inflammatory Bowel Disease Center, Division of
Gastroenterology, NYU Langone Health, New York, NY, USA
| | - Thomas Ullman
- Division of Gastroenterology, Montefiore
Medical Center, Bronx, NY, USA
| | - Keith Sultan
- Division of Gastroenterology, Northwell
Health, North Shore University Hospital and Long Island Jewish Medical
Center, Great Neck, NY, USA
| | - Dana J. Lukin
- Jill Roberts Center for Inflammatory Bowel
Disease, Division of Gastroenterology and Hepatology, Department of
Medicine, Weill Cornell Medical College, New York, NY, USA
| | - Jean-Frederic Colombel
- The Dr. Henry D. Janowitz Division of
Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY,
USA
| | - Jordan E. Axelrad
- Inflammatory Bowel Disease Center, Division of
Gastroenterology, NYU Langone Health, New York, NY, USA
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10
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Impact of SARS-CoV-2 Infection on the Course of Inflammatory Bowel Disease in Patients Treated with Biological Therapeutic Agents: A Case-Control Study. Biomedicines 2022; 10:biomedicines10040843. [PMID: 35453593 PMCID: PMC9029341 DOI: 10.3390/biomedicines10040843] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 01/27/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has raised concerns in patients with inflammatory bowel disease (IBD), not only due to consequences of coronavirus disease 2019 itself but also as a possible cause of IBD relapse. The main objective of this study was to assess the role of SARS-CoV-2 in IBD clinical recurrence in a cohort of patients undergoing biological therapy. Second, we evaluated the difference in C-reactive protein (CRP) levels between the start and end of the follow-up period (ΔCRP) and the rate of biological therapy discontinuation. Patients with IBD positive for SARS-CoV-2 infection were compared with non-infected patients. IBD recurrence was defined as the need for intensification of current therapy. We enrolled 95 IBD patients with SARS-CoV-2 infection and 190 non-infected patients. During follow-up, 11 of 95 (11.6%) SARS-CoV-2-infected patients experienced disease recurrence compared to 21 of 190 (11.3%) in the control group (p = 0.894). Forty-six (48.4%) SARS-CoV-2-infected patients discontinued biological therapy versus seven (3.7%) in the control group (p < 0.01). In the multivariate analysis, biological agent discontinuation (p = 0.033) and ΔCRP (p = 0.017), but not SARS-CoV-2 infection (p = 0.298), were associated with IBD recurrence. SARS-CoV-2 infection was not associated with increased IBD recurrence rates in this cohort of patients treated with biological agents.
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11
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Attauabi M, Dahlerup JF, Poulsen A, Hansen MR, Vester-Andersen MK, Prahm AP, Pedersen N, Larsen L, Jess T, Neumann A, Haderslev KV, Molazahi A, Lødrup AB, Glerup H, Oppfeldt AM, Jensen MD, Theede K, Kiszka-Kanowitz M, Seidelin JB, Burisch J. Association Between the Clinical, Biochemical, and Endoscopic Activity of Inflammatory Bowel Diseases and Severity and Long-term Outcomes of Coronavirus Disease 2019-A Population-based Study. Inflamm Bowel Dis 2022; 28:1618-1622. [PMID: 35325137 PMCID: PMC8992288 DOI: 10.1093/ibd/izac052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Indexed: 12/29/2022]
Abstract
This brief report investigated the impact of clinical, biochemical, and endoscopic activity of IBD on the severity and long-term outcomes of COVID-19 in a prospective population-based cohort. The study did not identify any association between IBD activity and COVID-19 outcomes.
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Affiliation(s)
- Mohamed Attauabi
- Address correspondence to: Mohamed Attauabi, MD, PhD Fellow, Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Denmark, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark ()
| | - Jens Frederik Dahlerup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
| | - Anja Poulsen
- Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Malte Rosager Hansen
- Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark
| | | | | | - Natalia Pedersen
- Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark
| | - Lone Larsen
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark
| | - Tine Jess
- Department of Gastroenterology and Hepatology, Aalborg University Hospital, Aalborg, Denmark,National Center of Excellence for Molecular Prediction of Inflammatory Bowel Disease PREDICT, Department of Clinical Medicine, Aalborg University, Copenhagen, Denmark
| | - Anders Neumann
- Department of Internal Medicine, Region Hospital Viborg, Viborg, Denmark
| | - Kent V Haderslev
- Department of Gastroenterology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Akbar Molazahi
- Department of Internal Medicine, Holbaek Hospital, Holbaek, Denmark
| | - Anders Berg Lødrup
- Department of Internal Medicine, Region Hospital West Jutland, Herning, Denmark
| | - Henning Glerup
- Department of Internal Medicine, Region Hospital Silkeborg, Silkeborg, Denmark
| | | | - Michael Dam Jensen
- Department of Internal Medicine, Section of Gastroenterology, Lillebaelt Hospital, Vejle, Denmark
| | - Klaus Theede
- Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark,Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark
| | - Marianne Kiszka-Kanowitz
- Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark,Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark
| | - Jakob Benedict Seidelin
- Department of Gastroenterology and Hepatology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Johan Burisch
- Gastrounit, Medical Section, Hvidovre University Hospital, Hvidovre, Denmark,Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, University of Copenhagen, Hvidovre Hospital, Denmark
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12
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Zabana Y, Marín-Jiménez I, Rodríguez-Lago I, Vera I, Martín-Arranz MD, Guerra I, Gisbert JP, Mesonero F, Benítez O, Taxonera C, Ponferrada-Díaz Á, Piqueras M, Lucendo AJ, Caballol B, Mañosa M, Martínez-Montiel P, Bosca-Watts M, Gordillo J, Bujanda L, Manceñido N, Martínez-Pérez T, López A, Rodríguez-Gutiérrez C, García-López S, Vega P, Rivero M, Melcarne L, Calvo M, Iborra M, Barreiro de-Acosta M, Sicilia B, Barrio J, Pérez JL, Busquets D, Pérez-Martínez I, Navarro-Llavat M, Hernández V, Argüelles-Arias F, Ramírez Esteso F, Meijide S, Ramos L, Gomollón F, Muñoz F, Suris G, de Zarate JO, Huguet JM, Llaó J, García-Sepulcre MF, Sierra M, Durà M, Estrecha S, Fuentes Coronel A, Hinojosa E, Olivan L, Iglesias E, Gutiérrez A, Varela P, Rull N, Gilabert P, Hernández-Camba A, Brotons A, Ginard D, Sesé E, Carpio D, Aceituno M, Cabriada JL, González-Lama Y, Jiménez L, Chaparro M, López-San Román A, Alba C, Plaza-Santos R, Mena R, Tamarit-Sebastián S, Ricart E, Calafat M, Olivares S, Navarro P, Bertoletti F, Alonso-Galán H, Pajares R, Olcina P, Manzano P, Domènech E, Esteve M. Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry. J Clin Med 2022; 11:421. [PMID: 35054116 PMCID: PMC8781643 DOI: 10.3390/jcm11020421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/23/2021] [Accepted: 01/06/2022] [Indexed: 02/04/2023] Open
Abstract
We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March-July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8-27 and 4.5, 95% CI: 1.3-15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3-11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.
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Affiliation(s)
- Yamile Zabana
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
| | | | - Iago Rodríguez-Lago
- Gastroenterology Department, Hospital Universitario de Galdakao, 48960 Galdakao, Spain; (I.R.-L.); (J.L.C.)
- Biocruces Bizkaia Health Research Institute, 48960 Galdakao, Spain
| | - Isabel Vera
- Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain; (I.V.); (Y.G.-L.)
| | | | - Iván Guerra
- Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain; (I.G.); (L.J.)
- Instituto de Investigación Hospital Universitario La Paz (IdiPaz), 28046 Madrid, Spain
| | - Javier P. Gisbert
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Department of Gastroenterology, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, Spain
| | - Francisco Mesonero
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (F.M.); (A.L.-S.R.)
| | - Olga Benítez
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
| | - Carlos Taxonera
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (C.T.); (C.A.)
- Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], 28040 Madrid, Spain
| | | | - Marta Piqueras
- Consorci Sanitari de Terrassa, 08227 Terrassa, Spain; (M.P.); (R.M.)
| | - Alfredo J. Lucendo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, Spain
- Hospital General de Tomelloso, 13700 Tomelloso, Spain;
| | - Berta Caballol
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Clínic de Barcelona-IDIBAPS, 08036 Barcelona, Spain
| | - Míriam Mañosa
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
| | - Pilar Martínez-Montiel
- Fundación Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (P.M.-M.); (S.O.)
| | - Maia Bosca-Watts
- Hospital Clinic Universitari de Valencia, 46010 Valencia, Spain; (M.B.-W.); (P.N.)
| | - Jordi Gordillo
- Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (J.G.); (F.B.)
| | - Luis Bujanda
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitario Donostia, Instituto Biodonostia, 20014 San Sebastián, Spain;
- Universidad del País Vasco (UPV/EHU), 48940 Leioua, Spain
| | - Noemí Manceñido
- Hospital Universitario Infanta Sofía, 28703 San Sebastián de los Reyes, Spain; (N.M.); (R.P.)
| | | | - Alicia López
- Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Hospital del Mar, 08003 Barcelona, Spain;
| | | | | | - Pablo Vega
- Complexo Hospitalario Universitario de Ourense, 32005 Ourense, Spain;
| | - Montserrat Rivero
- Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - Luigi Melcarne
- Hospital Universitari Parc Taulí, 08208 Sabadell, Spain;
| | - Maria Calvo
- Hospital San Pedro-Logroño, 26006 Logroño, Spain;
| | - Marisa Iborra
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitario y Politécnico de la Fe de Valencia, 46026 Valencia, Spain
| | | | | | - Jesús Barrio
- Hospital Universitario Río Hortega (HURH), 47012 Valladolid, Spain;
| | - José Lázaro Pérez
- Hospital Universitario Fundación de Alcorcón, 28922 Alcorcón, Spain;
| | - David Busquets
- Hospital Universitari de Girona Doctor Josep Trueta, 17007 Girona, Spain;
| | - Isabel Pérez-Martínez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | | | | | | | | | - Susana Meijide
- Hospital Universitario de Cruces, 48903 Barakaldo, Spain;
| | - Laura Ramos
- Hospital Universitario de Canarias, 38320 San Cristobal de la Laguna, Spain;
| | - Fernando Gomollón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Clínico Universitario “Lozano Blesa” and IIS Aragón, 50009 Zaragoza, Spain
| | - Fernando Muñoz
- Hospital Universitario de Salamanca, 37007 Salamanca, Spain;
| | - Gerard Suris
- Hospital Universitari de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain;
| | | | - José María Huguet
- Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain;
| | - Jordina Llaó
- Althaia Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain;
| | | | - Mónica Sierra
- Complejo Asistencial Universitario de León, 24071 León, Spain;
| | - Miguel Durà
- Hospital Clínico de Valladolid, 47003 Valladolid, Spain;
| | | | | | | | | | - Eva Iglesias
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía de Córdoba, 14004 Cordoba, Spain;
| | - Ana Gutiérrez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital General Universitario de Alicante, 03010 Alicante, Spain
| | - Pilar Varela
- Hospital Universitario de Cabueñes, 33394 Gijón, Spain;
| | - Núria Rull
- Hospital Universitario Son Llàtzer, 07198 Palma, Spain;
| | - Pau Gilabert
- Hospital de Viladecans, 08840 Viladecans, Spain;
| | | | | | - Daniel Ginard
- Hospital Universitario Son Espases, 07120 Palma, Spain;
| | - Eva Sesé
- Hospital Universitari Arnau de Vilanova de Lleida, 25198 Lleida, Spain;
| | - Daniel Carpio
- Complexo Hospitalario de Pontevedra, 36071 Pontevedra, Spain;
| | - Montserrat Aceituno
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
| | - José Luis Cabriada
- Gastroenterology Department, Hospital Universitario de Galdakao, 48960 Galdakao, Spain; (I.R.-L.); (J.L.C.)
- Biocruces Bizkaia Health Research Institute, 48960 Galdakao, Spain
| | - Yago González-Lama
- Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain; (I.V.); (Y.G.-L.)
| | - Laura Jiménez
- Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain; (I.G.); (L.J.)
- Instituto de Investigación Hospital Universitario La Paz (IdiPaz), 28046 Madrid, Spain
| | - María Chaparro
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Department of Gastroenterology, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-IP), 28006 Madrid, Spain
| | | | - Cristina Alba
- Hospital Clínico San Carlos, 28040 Madrid, Spain; (C.T.); (C.A.)
- Instituto de Investigación del Hospital Clínico San Carlos [IdISSC], 28040 Madrid, Spain
| | - Rocío Plaza-Santos
- Hospital Universitario Infanta Leonor, 28031 Madrid, Spain; (Á.P.-D.); (R.P.-S.)
| | - Raquel Mena
- Consorci Sanitari de Terrassa, 08227 Terrassa, Spain; (M.P.); (R.M.)
| | | | - Elena Ricart
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Clínic de Barcelona-IDIBAPS, 08036 Barcelona, Spain
| | - Margalida Calafat
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
| | - Sonsoles Olivares
- Fundación Hospital Universitario Doce de Octubre, 28041 Madrid, Spain; (P.M.-M.); (S.O.)
| | - Pablo Navarro
- Hospital Clinic Universitari de Valencia, 46010 Valencia, Spain; (M.B.-W.); (P.N.)
| | - Federico Bertoletti
- Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (J.G.); (F.B.)
| | - Horacio Alonso-Galán
- Hospital Universitario Donostia, Instituto Biodonostia, 20014 San Sebastián, Spain;
- Universidad del País Vasco (UPV/EHU), 48940 Leioua, Spain
| | - Ramón Pajares
- Hospital Universitario Infanta Sofía, 28703 San Sebastián de los Reyes, Spain; (N.M.); (R.P.)
| | - Pablo Olcina
- Hospital Virgen de la Luz, 16002 Cuenca, Spain; (T.M.-P.); (P.O.)
| | - Pamela Manzano
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
| | - Eugeni Domènech
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
- Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain
| | - Maria Esteve
- Hospital Universitari Mútua Terrassa, 08221 Terrassa, Spain; (O.B.); (M.A.); (P.M.); (M.E.)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), 28029 Madrid, Spain; (J.P.G.); (A.J.L.); (B.C.); (M.M.); (L.B.); (M.I.); (F.G.); (A.G.); (M.C.); (E.R.); (M.C.); (E.D.)
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