Ali Reza Sima
1 
, Bahar Saberzadeh-Ardestani
1, Homayoon Vahedi
1, Hafez Fakheri
2, Fariborz Mansour-Ghanaei
3, Iradj Maleki
2, Siavosh Nasseri-Moghaddam
1, Hasan Vosoghinia
4, Mohammad Reza Ghadir
5, Ahmad Hormati
5,6, Amir Kasaeian
1,7, Amir Reza Radmard
8, Bardia Khosravi
1, Masoud Malekzadeh
1, Sudabeh Alatab
1, Anahita Sadeghi
1, Nayyereh Aminisani
9, Hossein Poustchi
1, Elnaz Gonoudi
1, Amir Anushiravani
1, Maryam Rayatpisheh
1, Jean-Frederic Colombel
10, Ryan C. Ungaro
10* , Reza Malekzadeh
1* 1 Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
2 Gut and Liver Research Center, Mazandaran University of Medical Sciences, Sari, Iran
3 Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
4 Gastroenterology and Hematology Department, Faculty of Medicine, Ghaem Hospital, Mashhad, Iran
5 Gastroenterology and Hepatology Diseases Research Center, Qom University of Medical Science, Qom, Iran
6 Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
7 Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran
8 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
9 Department of Epidemiology and Statistics, Faculty of Health Sciences, Neyshabur University of Medical Sciences, Neyshabur, Iran
10 The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, New York, USA
*Corresponding Authors: *Corresponding Authors: Ryan C. Ungaro MD, MS; Assistant Professor of Medicine, The Henry D. Janowitz Division of Gastroenterology Icahn School of Medicine at Mount Sinai, 17 E 102nd St 5th Floor, New York, NY 10029, USA. Tel: 212-241-4514, Email: , Email:
Ryan.ungaro@mssm.edu; *Corresponding Authors: Reza Malekzadeh, MD, AGAF; Professor of Medicine, Director Digestive Disease Research Institute, Tehran University of medical Sciences, Shariati hospital Postal Code: 14117-13135, Tel:+98 (21) 824- 15555, E-mail: dr.reza.malekzadeh@gmail.com; , Email:
malek@tums.ac.ir
Abstract
Background: Most data on the effect of inflammatory bowel disease (IBD) and its treatments on coronavirus disease 2019 (COVID-19) outcomes have not had non-IBD comparators. Hence, we aimed to describe COVID-19 outcomes in IBD compared to non-IBD patients.
Methods: We conducted a prospective cohort study of registered IBD patients with confirmed COVID-19 from six provinces in Iran from February to April 2020. Proven COVID-19 patients were followed up at four weeks and the frequency of outcomes was assessed. Multivariable logistic regression was used to assess associations between demographics, clinical characteristics and COVID-19 outcomes.
Results: Overall, 2159 IBD patients and 4721 household members were enrolled, with 84 (3.9%) and 49 (1.1%) participants having confirmed COVID-19, respectively. Household spread of COVID-19 was not common in this cohort (1.2%). While hospitalization was significantly more frequent in IBD patients compared with non-IBD household members (27.1% vs. 6.0%, P=0.002), there was no significant difference in the frequency of severe cases. Age and presence of IBD were positively associated with hospitalization in IBD compared with non-IBD household members (OR: 1.06, 95% CI: 1.03-1.10; OR: 5.7, 95% CI: 2.02– 16.07, respectively). Age, presence of new gastrointestinal symptoms, and 5-aminosalicylic acid (5-ASA) use were associated with higher hospitalization rate in IBD patients (OR: 1.13, 95% CI: 1.05–1.23; OR: 6.49, 95% CI: 1.87–22.54; OR: 6.22, 95% CI: 1.90–20.36, respectively). Anti-tumor necrosis factor (TNF) was not associated with more severe outcomes.
Conclusion: Age, presence of new gastrointestinal symptoms and use of 5-ASA were associated with increased hospitalization rate among IBD patients, while anti-TNF therapy had no statistical association.