Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease: propensity matched research network analysis

Yousaf Hadi; Parambir S. Dulai; Justin Kupec; Nabeeha Mohy-Ud-Din; Vipul Jairath; Francis A. Farraye; Gursimran S. Kochhar

doi:10.1111/apt.16730

Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease: propensity matched research network analysis

Yousaf Hadi, Parambir S. Dulai, Justin Kupec, Nabeeha Mohy-Ud-Din, Vipul Jairath, Francis A. Farraye, Gursimran S. Kochhar^*

^*Corresponding author for this work

Medicine, Gastroenterology Division

Research output: Contribution to journal › Article › peer-review

44 Scopus citations

Abstract

Background: Accurate estimates for the risk of COVID-19 in IBD, and an understanding of the impact of COVID-19 on IBD course and the risk of incident post-infectious IBD are needed. Aims: To estimate the risk of COVID-19 in IBD and study its impact on IBD course and the risk of incident post-infectious IBD. Methods: A retrospective propensity score matched cohort study utilising multi-institutional research network TriNetX. COVID-19 patients with and without IBD were identified to quantify the risk of COVID-19 in patients with IBD, COVID-19 outcomes in patients with IBD and the impact of COVID-19 on IBD disease course. The risk of incident post-infectious IBD in COVID-19 patients was compared to the population not infected with COVID-19 during a similar time period. Results: Incidence rate ratio for COVID-19 was lower in IBD patients compared to the non-IBD population (0.79, 95% CI: 0.72-0.86). COVID-19-infected patients with IBD were at increased risk for requiring hospitalisation compared to non-IBD population (RR: 1.17, 95% CI: 1.02-1.34) with no differences in need for mechanical ventilation or mortality. Patients with IBD on steroids were at an increased risk for critical care need (RR: 2.22, 95% CI: 1.29-3.82). Up to 7% of patients with IBD infected with COVID-19 suffered an IBD flare 3-months post-infection. Risk for incident IBD post-COVID was lower than that seen in the non-COVID population (RR: 0.64, 95% CI: 0.54-0.65). Conclusion: We observed no increase in risk for COVID-19 amongst patients with IBD or risk for de novo IBD after COVID-19 infection. We confirmed prior observations regarding the impact of steroid use on COVID-19 severity in patients with IBD.

Original language	English (US)
Pages (from-to)	191-200
Number of pages	10
Journal	Alimentary Pharmacology and Therapeutics
Volume	55
Issue number	2
DOIs	https://doi.org/10.1111/apt.16730
State	Published - Jan 2022

Funding

GS Kochhar, Nabeeha Mohy‐Ud‐Din, Yousaf Hadi: No conflict of interest. Justin Kupec: Consultant for BMS. Vipul Jairath: consulting/advisory board fees from AbbVie, Alimentiv Inc (formerly Robarts Clinical Trials), Arena Pharmaceuticals, Asieris, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Reistone Biopharma, Roche, Sandoz, Takeda, Topivert; speaker’s fees from AbbVie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda. PS Dulai: Supported by an American Gastroenterology Association Research Scholar Award and an NIDDK P30 centre grant (DK120515). Has received consulting and/or grant support from Takeda, Janssen, Pfizer, AbbVie, Prometheus, Gilead, BMS, Lily and serves as an advisor for DigbiHealth. Francis A. Farraye: Consultant for BMS, Braintree Labs, Gilead, GSK, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Lilly and Theravance. Declaration of personal interests: Declaration of personal interests: GS Kochhar, Nabeeha Mohy-Ud-Din, Yousaf Hadi: No conflict of interest. Justin Kupec: Consultant for BMS. Vipul Jairath: consulting/advisory board fees from AbbVie, Alimentiv Inc (formerly Robarts Clinical Trials), Arena Pharmaceuticals, Asieris, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Reistone Biopharma, Roche, Sandoz, Takeda, Topivert; speaker?s fees from AbbVie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda. PS Dulai: Supported by an American Gastroenterology Association Research Scholar Award and an NIDDK P30 centre grant (DK120515). Has received consulting and/or grant support from Takeda, Janssen, Pfizer, AbbVie, Prometheus, Gilead, BMS, Lily and serves as an advisor for DigbiHealth. Francis A. Farraye: Consultant for BMS, Braintree Labs, Gilead, GSK, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Lilly and Theravance.

ASJC Scopus subject areas

Gastroenterology
Pharmacology (medical)
Hepatology

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10.1111/apt.16730

Cite this

@article{f0fa327467884a47a2573fbafacd48aa,

title = "Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease: propensity matched research network analysis",

abstract = "Background: Accurate estimates for the risk of COVID-19 in IBD, and an understanding of the impact of COVID-19 on IBD course and the risk of incident post-infectious IBD are needed. Aims: To estimate the risk of COVID-19 in IBD and study its impact on IBD course and the risk of incident post-infectious IBD. Methods: A retrospective propensity score matched cohort study utilising multi-institutional research network TriNetX. COVID-19 patients with and without IBD were identified to quantify the risk of COVID-19 in patients with IBD, COVID-19 outcomes in patients with IBD and the impact of COVID-19 on IBD disease course. The risk of incident post-infectious IBD in COVID-19 patients was compared to the population not infected with COVID-19 during a similar time period. Results: Incidence rate ratio for COVID-19 was lower in IBD patients compared to the non-IBD population (0.79, 95% CI: 0.72-0.86). COVID-19-infected patients with IBD were at increased risk for requiring hospitalisation compared to non-IBD population (RR: 1.17, 95% CI: 1.02-1.34) with no differences in need for mechanical ventilation or mortality. Patients with IBD on steroids were at an increased risk for critical care need (RR: 2.22, 95% CI: 1.29-3.82). Up to 7% of patients with IBD infected with COVID-19 suffered an IBD flare 3-months post-infection. Risk for incident IBD post-COVID was lower than that seen in the non-COVID population (RR: 0.64, 95% CI: 0.54-0.65). Conclusion: We observed no increase in risk for COVID-19 amongst patients with IBD or risk for de novo IBD after COVID-19 infection. We confirmed prior observations regarding the impact of steroid use on COVID-19 severity in patients with IBD.",

author = "Yousaf Hadi and Dulai, {Parambir S.} and Justin Kupec and Nabeeha Mohy-Ud-Din and Vipul Jairath and Farraye, {Francis A.} and Kochhar, {Gursimran S.}",

note = "Funding Information: GS Kochhar, Nabeeha Mohy‐Ud‐Din, Yousaf Hadi: No conflict of interest. Justin Kupec: Consultant for BMS. Vipul Jairath: consulting/advisory board fees from AbbVie, Alimentiv Inc (formerly Robarts Clinical Trials), Arena Pharmaceuticals, Asieris, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Reistone Biopharma, Roche, Sandoz, Takeda, Topivert; speaker{\textquoteright}s fees from AbbVie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda. PS Dulai: Supported by an American Gastroenterology Association Research Scholar Award and an NIDDK P30 centre grant (DK120515). Has received consulting and/or grant support from Takeda, Janssen, Pfizer, AbbVie, Prometheus, Gilead, BMS, Lily and serves as an advisor for DigbiHealth. Francis A. Farraye: Consultant for BMS, Braintree Labs, Gilead, GSK, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Lilly and Theravance. Declaration of personal interests: Funding Information: Declaration of personal interests: GS Kochhar, Nabeeha Mohy-Ud-Din, Yousaf Hadi: No conflict of interest. Justin Kupec: Consultant for BMS. Vipul Jairath: consulting/advisory board fees from AbbVie, Alimentiv Inc (formerly Robarts Clinical Trials), Arena Pharmaceuticals, Asieris, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Reistone Biopharma, Roche, Sandoz, Takeda, Topivert; speaker?s fees from AbbVie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda. PS Dulai: Supported by an American Gastroenterology Association Research Scholar Award and an NIDDK P30 centre grant (DK120515). Has received consulting and/or grant support from Takeda, Janssen, Pfizer, AbbVie, Prometheus, Gilead, BMS, Lily and serves as an advisor for DigbiHealth. Francis A. Farraye: Consultant for BMS, Braintree Labs, Gilead, GSK, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Lilly and Theravance. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons Ltd",

year = "2022",

month = jan,

doi = "10.1111/apt.16730",

language = "English (US)",

volume = "55",

pages = "191--200",

journal = "Alimentary Pharmacology and Therapeutics",

issn = "0269-2813",

publisher = "Wiley-Blackwell",

number = "2",

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TY - JOUR

T1 - Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease

T2 - propensity matched research network analysis

AU - Hadi, Yousaf

AU - Dulai, Parambir S.

AU - Kupec, Justin

AU - Mohy-Ud-Din, Nabeeha

AU - Jairath, Vipul

AU - Farraye, Francis A.

AU - Kochhar, Gursimran S.

N1 - Funding Information: GS Kochhar, Nabeeha Mohy‐Ud‐Din, Yousaf Hadi: No conflict of interest. Justin Kupec: Consultant for BMS. Vipul Jairath: consulting/advisory board fees from AbbVie, Alimentiv Inc (formerly Robarts Clinical Trials), Arena Pharmaceuticals, Asieris, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Reistone Biopharma, Roche, Sandoz, Takeda, Topivert; speaker’s fees from AbbVie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda. PS Dulai: Supported by an American Gastroenterology Association Research Scholar Award and an NIDDK P30 centre grant (DK120515). Has received consulting and/or grant support from Takeda, Janssen, Pfizer, AbbVie, Prometheus, Gilead, BMS, Lily and serves as an advisor for DigbiHealth. Francis A. Farraye: Consultant for BMS, Braintree Labs, Gilead, GSK, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Lilly and Theravance. Declaration of personal interests: Funding Information: Declaration of personal interests: GS Kochhar, Nabeeha Mohy-Ud-Din, Yousaf Hadi: No conflict of interest. Justin Kupec: Consultant for BMS. Vipul Jairath: consulting/advisory board fees from AbbVie, Alimentiv Inc (formerly Robarts Clinical Trials), Arena Pharmaceuticals, Asieris, Bristol Myers Squibb, Celltrion, Eli Lilly, Ferring, Fresenius Kabi, Galapagos, GlaxoSmithKline, Genentech, Gilead, Janssen, Merck, Mylan, Pandion, Pendopharm, Pfizer, Reistone Biopharma, Roche, Sandoz, Takeda, Topivert; speaker?s fees from AbbVie, Ferring, Galapagos, Janssen Pfizer Shire, Takeda. PS Dulai: Supported by an American Gastroenterology Association Research Scholar Award and an NIDDK P30 centre grant (DK120515). Has received consulting and/or grant support from Takeda, Janssen, Pfizer, AbbVie, Prometheus, Gilead, BMS, Lily and serves as an advisor for DigbiHealth. Francis A. Farraye: Consultant for BMS, Braintree Labs, Gilead, GSK, Innovation Pharmaceuticals, Janssen, Pfizer and Sebela. He sits on a DSMB for Lilly and Theravance. Publisher Copyright: © 2021 John Wiley & Sons Ltd

PY - 2022/1

Y1 - 2022/1

N2 - Background: Accurate estimates for the risk of COVID-19 in IBD, and an understanding of the impact of COVID-19 on IBD course and the risk of incident post-infectious IBD are needed. Aims: To estimate the risk of COVID-19 in IBD and study its impact on IBD course and the risk of incident post-infectious IBD. Methods: A retrospective propensity score matched cohort study utilising multi-institutional research network TriNetX. COVID-19 patients with and without IBD were identified to quantify the risk of COVID-19 in patients with IBD, COVID-19 outcomes in patients with IBD and the impact of COVID-19 on IBD disease course. The risk of incident post-infectious IBD in COVID-19 patients was compared to the population not infected with COVID-19 during a similar time period. Results: Incidence rate ratio for COVID-19 was lower in IBD patients compared to the non-IBD population (0.79, 95% CI: 0.72-0.86). COVID-19-infected patients with IBD were at increased risk for requiring hospitalisation compared to non-IBD population (RR: 1.17, 95% CI: 1.02-1.34) with no differences in need for mechanical ventilation or mortality. Patients with IBD on steroids were at an increased risk for critical care need (RR: 2.22, 95% CI: 1.29-3.82). Up to 7% of patients with IBD infected with COVID-19 suffered an IBD flare 3-months post-infection. Risk for incident IBD post-COVID was lower than that seen in the non-COVID population (RR: 0.64, 95% CI: 0.54-0.65). Conclusion: We observed no increase in risk for COVID-19 amongst patients with IBD or risk for de novo IBD after COVID-19 infection. We confirmed prior observations regarding the impact of steroid use on COVID-19 severity in patients with IBD.

AB - Background: Accurate estimates for the risk of COVID-19 in IBD, and an understanding of the impact of COVID-19 on IBD course and the risk of incident post-infectious IBD are needed. Aims: To estimate the risk of COVID-19 in IBD and study its impact on IBD course and the risk of incident post-infectious IBD. Methods: A retrospective propensity score matched cohort study utilising multi-institutional research network TriNetX. COVID-19 patients with and without IBD were identified to quantify the risk of COVID-19 in patients with IBD, COVID-19 outcomes in patients with IBD and the impact of COVID-19 on IBD disease course. The risk of incident post-infectious IBD in COVID-19 patients was compared to the population not infected with COVID-19 during a similar time period. Results: Incidence rate ratio for COVID-19 was lower in IBD patients compared to the non-IBD population (0.79, 95% CI: 0.72-0.86). COVID-19-infected patients with IBD were at increased risk for requiring hospitalisation compared to non-IBD population (RR: 1.17, 95% CI: 1.02-1.34) with no differences in need for mechanical ventilation or mortality. Patients with IBD on steroids were at an increased risk for critical care need (RR: 2.22, 95% CI: 1.29-3.82). Up to 7% of patients with IBD infected with COVID-19 suffered an IBD flare 3-months post-infection. Risk for incident IBD post-COVID was lower than that seen in the non-COVID population (RR: 0.64, 95% CI: 0.54-0.65). Conclusion: We observed no increase in risk for COVID-19 amongst patients with IBD or risk for de novo IBD after COVID-19 infection. We confirmed prior observations regarding the impact of steroid use on COVID-19 severity in patients with IBD.

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Incidence, outcomes, and impact of COVID-19 on inflammatory bowel disease: propensity matched research network analysis

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