HIGHLIGHTS
- Most inflammatory bowel diseases and COVID-19 patients were symptomatic, and fever was the main symptom.
- Patients with inflammatory bowel diseases and COVID-19 had more gastrointestinal symptoms than the general population with COVID-19.
- Use of salicylates, female gender and asthma were associated with COVID-19.
- Use of immunosuppressants or immunobiological drugs did not alter the clinical presentation of COVID-19.
ABSTRACT – Background –
Fortunately, much has been studied about COVID-19 in patients with inflammatory bowel diseases (IBD). Evidence suggests that these patients do not appear to be at increased risk of severe COVID-19. However, there are still some uncertainties regarding the clinical manifestations of COVID-19 in patients with immune-mediated diseases. Objective – This study aimed to describe the main symptoms of COVID-19 and their frequency in IBD patients and evaluate the impact of the IBD therapeutic drugs on clinical presentation of COVID-19 and to determine factors associated with COVID-19 in this population. Methods – Adult patients with IBD from three tertiary-care public, teaching hospitals in Ceará, Northeastern Brazil, were evaluated during one scheduled appointment from March to December 2020. Patients with possible or confirmed COVID-19 were compared with patients without COVID-19. Furthermore, incidences of each symptom were evaluated based on the use of IBD therapeutic drugs. Results – A total of 515 patients with IBD were included in the study: 234 with CD, and 281 with UC. Of these, 174 patients (34%) had possible/confirmed COVID-19 of whom 156 (90%) were symptomatic. Main symptoms were fever (65%) and headache (65%); gastrointestinal symptoms occurred in one third of patients and were higher than COVID-19 in general population. The factors associated with having COVID-19 were female gender (OR 1.71, 95%CI: 1.17–2.50); contact at home (OR 5.07, 95%CI: 3.31–7.78) and outside the home (OR 3.14, 95%CI: 2.10–4.71) with a case of COVID-19; work outside of the home (OR 1.87, 95%CI: 1.26–2.78); family history of COVID-19 (OR 2.29, 95%CI 1.58–3.33) use of salicylate (OR 1.71, 95%CI: 1.17–4.28); and asthma (OR 7.10, 95%CI: 1.46–34.57). Conclusion – IBD patients at high risk of COVID-19 infection may need to avoid salicylate therapy but further studies are necessary to confirm this association. Keywords – Inflammatory bowel disease; COVID-19; salicylates.
AUTORES
Mariana Rolim Fernandes MACEDO1, Carlos Arthur Fernandes SOBREIRA2, Carola Braz de LAVOR2, Camila Ribeiro RÔLA2, Ticiana Maria de Lavor ROLIM1, Francisco Sérgio Rangel de Paula PESSOA1, Milena Santana GIRÃO3, Caio César Furtado FREIRE3, Ranna Caroline Bezerra SIEBRA4, Isabele de Sá Silveira MELO4, Marcellus Henrique Loiola Ponte de SOUZA4, Lucia Libanez Bessa Campelo BRAGA4, Liana Perdigão MELLO5, Débora Bezerra SILVA5, Luís Arthur Brasil Gadelha FARIAS6,7, Maura Salaroli de OLIVEIRA6, Lauro Vieira PERDIGÃO NETO6 and Anna Sara LEVIN6
