2019 Novel Coronavirus Disease (COVID‐19) in patients with Inflammatory Bowel Diseases

Taxonera, Carlos; Sagastagoitia, Iñigo; Alba, Cristina; Mañas, Norberto; Olivares, David; Rey, Enrique

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.