Outcomes of the New COVID-19 Coronavirus Infection in 68 Patients with Inflammatory Bowel Diseases

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Abstract


Background. COVID-19 is an infectious respiratory syndrome with a wide range of manifestations and outcomes. Patients with inflammatory bowel disease (IBD) generally have a higher risk of infection, especially if they receive immunosuppressive therapy.

Aim — to describe the manifestations of COVID-19 in patients with IBD and to determine the risk factors for severe COVID-19.

Methods. The analysis included 68 patients with an established diagnosis of Crohn’s disease (CD) or ulcerative colitis and a confirmed new coronavirus infection. The diagnosis of coronavirus infection was established when SARS-CoV-2 was detected by PCR using nasopharyngeal smears, and computer tomography (CT) of the chest revealed inflammatory changes characteristic of coronavirus lung damage or high IgG and IgM titers based on the results of immunological blood analysis.

Results. 68 patients with IBD and COVID-19 were observed in the Department of IBD, including 27 (39.7%) patients with CD, 41 (60.3%) patients with UC. Among patients diagnosed with pneumonia, 100 % of patients received therapy with thiopurines and infliximab. 8 (11.8%) patients were diagnosed with COVID-19 during hospitalization for a severe IBD attack. There was no statistically significant difference between UC and CD patients in terms of disease activity (p = 0.13) during the period of coronavirus infection. In 37 patients (26 — UC, 11 — BC) with pneumonia (100%), there was an exacerbation of IBD. Statistical significance was found between the development of more severe lung damage (CT 3–4) and IBD activity at the time of diagnosis of COVID-19 (p < 0.001), the presence of comorbidities (p < 0.001) and taking GCS (p < 0.001) at the time of detection of COVID-19. However, the use of biological and immunosuppressive therapy was not associated with a higher risk of severe lung damage and the need for a ventilator. It was shown that the age of patients over 65 years was statistically correlated with the need for a ventilator (p = 0.02).

Conclusion. The exacerbation of the disease, especially in elderly patients with comorbidities, the use of glucocorticosteroids was associated with negative consequences of COVID-19, while biological and immunosuppressant drugs used for the treatment of IBD did not have such a negative effect.


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About the authors

Anna V. Kagramanova

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: kagramanova@me.com
ORCID iD: 0000-0002-3818-6205
SPIN-code: 4086-6745

Russian Federation, 86 Shosse Entuziastov, 111123, Moscow

MD, PhD, Senior Research Associate

Oleg V. Knyazev

Moscow Clinical Scientific Center Named after A.S. Loginov; Research Institute of Health Organization and Medical Management; State Scientific Centre of Coloproctology

Author for correspondence.
Email: oleg7@bk.ru
ORCID iD: 0000-0001-7250-0977
SPIN-code: 3268-0360

Russian Federation, Moscow; Moscow; Moscow

MD, PhD, Leading Research Associate

Alexei V. Veselov

Research Institute of Health Organization and Medical Management

Email: a_veselov82@mail.ru
ORCID iD: 0000-0003-3115-1787
SPIN-code: 9333-8673

Russian Federation, Moscow

MD, PhD, Leading Research Associate

Tatyana V. Shkurko

Research Institute of Health Organization and Medical Management

Email: 89165457033@mail.ru
ORCID iD: 0000-0002-7502-2437
SPIN-code: 9073-3362

Russian Federation, Moscow

PhD

Irina A. Li

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: i.li@mknc.ru
ORCID iD: 0000-0002-9508-7502
SPIN-code: 6336-3049

Russian Federation, Moscow

PhD

Nina A. Fadeeva

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: chuevana@mail.ru
ORCID iD: 0000-0002-0524-2514
SPIN-code: 6047-7590

Russian Federation, Moscow

MD, PhD, Senior Research Associate

Dmitriy S. Kulakov

Moscow Clinical Scientific Center Named after A.S. Loginov; Research Institute of Health Organization and Medical Management

Email: dm.kulakov77@gmail.com
ORCID iD: 0000-0002-0855-5217
SPIN-code: 9966-0006

Russian Federation, Moscow; Moscow

Junior Research Associate

Albina A. Lishchinskaya

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: lalbina@inbox.ru
ORCID iD: 0000-0001-7891-2702
SPIN-code: 9369-9674

Russian Federation, Moscow

MD, PhD, Senior Research Associate

Mariya Y. Zvyaglova

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: zwmr306@mail.ru
ORCID iD: 0000-0002-7937-2346
SPIN-code: 6119-5774

Russian Federation, Moscow

Junior Research Associate

Marina E. Chernova

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: m.chernova@mknc.ru
ORCID iD: 0000-0002-6127-1723
SPIN-code: 1053-0790

Russian Federation, Moscow

MD, PhD

Asfold I. Parfenov

Moscow Clinical Scientific Center Named after A.S. Loginov

Email: asfold@mail.ru
ORCID iD: 0000-0002-9782-4860
SPIN-code: 5142-3632

Russian Federation, Moscow

MD, PhD, Professor

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