Systematic review on IBD patients with COVID-19: it is time to take stock
Date
2020Author
D’Amico, Ferdinando
Danese, Silvio
Peyrin-Biroulet, Laurent
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Abstract
Background and aims: Clinical characteristics’ data of patients with inflammatory bowel
diseases (IBD) with COVID-19 are scarce. Aim of our systematic review was to investigate
symptoms and diagnostic-therapeutic management of IBD patients with COVID-19.
Methods : We searched Pubmed, Embase, Web of Science, and MedRxiv up to July 29,
2020, to identify all studies reporting clinical information on adult and pediatric IBD patients
with confirmed COVID-19.
Results : Twenty-three studies met our inclusion criteria including 243,760 IBD patients.
COVID-19 was diagnosed in 1,028 patients (509 Crohn’s disease (49.5%), 428 ulcerative
colitis (41.6%), 49 indeterminate colitis (4.8%), and 42 missing data (4.1%)) accounting for a
cumulative prevalence of 0.4%. Viral infection occurred more frequently in males than in
females (56.5% vs 39.7%) and mean age ranged from 14 to 85 years. The most common
symptoms were fever (48.3%), cough (46.5%), and diarrhea (20.5%) and COVID-19
diagnosis was mainly achieved through polymerase chain reaction (PCR) analysis of
nasopharyngeal swabs (94.4%) and chest computed tomography scans (38.9%).
Hydroxychloroquine (23.9%), lopinavir/ritonavir (8.2%), steroids (3.2%), and antibiotics
(3.1%) were the most used drugs. Overall, about a third of patients were hospitalized (30.6%)
and 11.4% of them required admission to intensive care unit. In total, 29 COVID-19-related
deaths were reported (3.8%) and increasing age and presence of comorbidities were
recognized as risk factors for COVID-19 and negative outcomes.
Conclusion : Diarrhea occurs more frequently in IBD patients with COVID-19 than in nonIBD population. Further studies are needed to define the optimal diagnostic-therapeutic
approach in IBD patients with COVID-19.
Palabras clave
COVID-19; SARS-CoV-2; Crohn’s disease; Ulcerative colitis; Inflammatory bowel diseaseLink to resource
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