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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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