2019 novel coronavirus disease (COVID‐19) in patients with inflammatory bowel diseases

Abstract

Background Data on patients with inflammatory bowel diseases (IBD) who have had 2019 novel coronavirus (SARS‐CoV‐2) disease (COVID‐19) are lacking. Aim To report the clinical characteristics, including gastrointestinal symptoms, of COVID‐19 in IBD patients, and to assess the risk of COVID‐19 in IBD. Methods This case series included consecutive IBD patients with laboratory‐confirmed COVID‐19. Age‐adjusted cumulative incidences were compared with the general population in the Madrid region. Results Through April 8, 12 patients of 1918 IBD patients were diagnosed of COVID‐19. The average age was 52 years, 75% of the patients were female, and 58.3% had Crohn’s disease. Seven patients (58%) were on maintenance treatment with immunomodulators/biologics, of these 4 with combined therapy (33%). Eight patients (66%) required hospitalization (1 intensive care unit admission, and 2 deaths), and 4 patients were isolated at home. Nine patients had diarrhoea ranging between 4‐10 loose stools per day (mean 5.4, SD 1.6). In 5 patients (42%) diarrhoea was a presenting symptom. In 2 patients, diarrhoea was the only symptom at debut. Cumulative incidence of COVID‐19 was 6.1 per 1000 IBD patients. IBD patients had a lower adjusted incidence ratio of COVID‐19 (OR 0.74, 95% CI 0.70‐0.77; p<0.001), and a similar associated mortality ratio (OR 0.95, 95% CI: 0.84‐1.06; p=0.36), compared with the general population. Conclusions IBD patients do not have an increased risk of COVID‐19 and associated mortality compared with the general population. In many IBD patients diarrhoea was a presenting symptom, and sometimes, was the only symptom at onset of COVID‐19.