TOPLINE:
Inflammatory bowel disease (IBD) therapies for patients may need to be briefly halted during treatment for COVID-19, but it does not escalate IBD flares, with prior vaccination for COVID-19 helping reduce complications from the virus.
METHODOLOGY:
- Patients with IBD who receive immunosuppressive agents are at an increased risk of developing severe SARS-CoV-2 infection; however, the effects of COVID-19 vaccination and treatment on the outcomes in patients with IBD are less known.
- Researchers assessed the effect of COVID-19 medications in 127 patients with IBD (age ≥ 18 years; 54% women) who were diagnosed with COVID-19 after the advent of vaccines and release of antiviral therapies.
- Patients were stratified into those who received treatment for COVID-19 (n = 44), defined as the use of antivirals and/or intravenous antibodies, and those who did not receive treatment for COVID-19 (n = 83).
- The primary outcome was the development of a severe SARS-CoV-2 infection (defined by the need for oxygen supplements, corticosteroids and/or antibiotic treatment, or hospitalization).
- The secondary outcomes were the percentage of patients who had their IBD therapy withheld and rates of IBD flare post COVID-19.
TAKEAWAY:
- The likelihood of being treated for COVID-19 was higher in patients on corticosteroids (odds ratio [OR], 4.61; P = .002) or in those undergoing advanced IBD therapies (OR, 2.78; P = .041) prior to infection.
- Advanced age at the time of infection (adjusted OR [aOR], 1.06; P = .018) and corticosteroid treatment prior to contracting COVID-19 (aOR, 9.86; P = .001) were associated with an increased risk for severe infection.
- After adjusting for multiple factors, the likelihood of withholding IBD treatment was higher in patients being treated for COVID-19 (aOR, 6.95; P = .007).
- Withholding advanced IBD therapies during acute COVID-19 did not increase post-infection IBD flares (P = .508), and prior vaccination for COVID-19 was protective against severe infection (aOR, 0.26; P = .041).
IN PRACTICE:
"Patients with IBD on advanced therapies were frequently treated for acute COVID-19. Although COVID-19 treatment was associated with temporary withholding of IBD therapy, it did not result in increased IBD flares," the authors wrote.
SOURCE:
The investigation, led by Laura C. Sahyoun, MD, Section of Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, was published online in Digestive Diseases and Sciences.
LIMITATIONS:
Owing to the small sample size, the outcomes comparing antivirals to intravenous antibodies and SARS-CoV-2 strain prevalence could not be assessed. This single-center study also may not reflect the different clinical practices pertaining to IBD and COVID-19 treatments.
DISCLOSURES:
The study did not receive any specific funding. One author reported receiving speaker fees and being part of advisory boards, and another author received research support and reported being a part of advisory boards.