Incidence of Severe COVID-19 Outcomes and Immunization Rates in Apulian Individuals with Inflammatory Bowel Disease: A Retrospective Cohort Study.

Francesco Paolo Bianchi, Antonella Contaldo, Maurizio Gaetano Polignano, Antonio Pisani
Author Information
  1. Francesco Paolo Bianchi: Health Prevention Department, Local Health Authority of Brindisi, 72100 Brindisi, Italy. ORCID
  2. Antonella Contaldo: National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy.
  3. Maurizio Gaetano Polignano: National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy. ORCID
  4. Antonio Pisani: National Institute of Gastroenterology, IRCCS S. De Bellis, Research Hospital, 70013 Castellana Grotte, Italy.

Abstract

The etiology of Inflammatory Bowel Disease (IBD) is not fully understood but is believed to involve a dysregulated immune response to intestinal microbiota in genetically susceptible individuals. Individuals with IBD are at increased risk of infections due to immunosuppressive treatments, comorbidities, and advanced age. Current evidence indicates that IBD patients are not at higher risk of SARS-CoV-2 infection compared to the general population, though the risk of severe outcomes remains debated. A retrospective observational study was conducted using Apulian regional health data from 2020 to 2022. This study included 1029 IBD patients and 3075 controls, matched by age and sex. COVID-19 incidence, hospitalization, and case fatality rates were analyzed alongside vaccination coverage. No significant differences in COVID-19 incidence (IRR = 0.97), hospitalization ( = 0.218), or lethality ( = 0.271) were evidenced between IBD patients and the general population. Vaccination rates were high in both groups, with slightly higher uptake in IBD patients. Multivariate analysis identified age and male sex as risk factors for severe COVID-19 outcomes, while vaccination significantly reduced hospitalization and lethality risks. IBD patients in Apulia do not have an increased risk of COVID-19 infection or severe outcomes compared to the general population. Vaccination is crucial in protecting IBD patients, and ongoing efforts to promote vaccination within this population are essential. Future research should focus on the impact of specific IBD treatments on COVID-19 outcomes and the long-term effectiveness of vaccines.

Keywords

References

  1. Lancet Gastroenterol Hepatol. 2021 Mar;6(3):218-224 [PMID: 33508241]
  2. Front Immunol. 2021 Sep 14;12:740249 [PMID: 34594343]
  3. Dig Liver Dis. 2022 Jun;54(6):713-721 [PMID: 35382972]
  4. Front Pediatr. 2023 Jan 17;10:1103713 [PMID: 36733765]
  5. Vaccines (Basel). 2023 Nov 02;11(11): [PMID: 38006015]
  6. BMC Gastroenterol. 2022 Aug 20;22(1):393 [PMID: 35987619]
  7. Inflamm Bowel Dis. 2021 Jun 15;27(7):1166-1169 [PMID: 33904584]
  8. Malays J Med Sci. 2023 Jun;30(3):84-92 [PMID: 37425387]
  9. Lancet Gastroenterol Hepatol. 2020 Jan;5(1):17-30 [PMID: 31648971]
  10. Clin Gastroenterol Hepatol. 2020 Aug;18(9):2134-2135 [PMID: 32360811]
  11. Immunol Rev. 2022 Sep;310(1):27-46 [PMID: 35733376]
  12. J Clin Med. 2022 May 09;11(9): [PMID: 35566802]
  13. Lancet Gastroenterol Hepatol. 2016 Dec;1(4):307-316 [PMID: 28404201]
  14. United European Gastroenterol J. 2021 Mar;9(2):177-192 [PMID: 33704918]
  15. Inflamm Bowel Dis. 2022 Oct 3;28(10):1497-1505 [PMID: 34871388]
  16. J Crohns Colitis. 2020 Sep 16;14(9):1334-1336 [PMID: 32215548]
  17. Sci Rep. 2022 Dec 9;12(1):21333 [PMID: 36494448]
  18. BMC Gastroenterol. 2017 Apr 14;17(1):52 [PMID: 28407755]
  19. Lancet Reg Health Eur. 2023 May;28:100614 [PMID: 37131863]
  20. Aliment Pharmacol Ther. 2022 Jan;55(2):191-200 [PMID: 34904240]
  21. Vaccines (Basel). 2023 Sep 25;11(10): [PMID: 37896927]
  22. J Crohns Colitis. 2014 Jun;8(6):443-68 [PMID: 24613021]
  23. Lancet Gastroenterol Hepatol. 2022 Nov;7(11):1005-1015 [PMID: 36088954]
  24. Pharmacol Res. 2020 Oct;160:105061 [PMID: 32629021]
  25. Gut. 2020 Jul;69(7):1213-1217 [PMID: 32354990]
  26. Front Public Health. 2022 Nov 17;10:1029190 [PMID: 36466473]
  27. Br J Haematol. 2023 Jun;201(6):1072-1080 [PMID: 36942786]
  28. Pathogens. 2023 Jun 22;12(7): [PMID: 37513709]
  29. Vaccines (Basel). 2023 Nov 24;11(12): [PMID: 38140156]
  30. Inflamm Bowel Dis. 2022 Aug 1;28(8):1265-1279 [PMID: 34718595]
  31. Hum Vaccin Immunother. 2024 Dec 31;20(1):2349319 [PMID: 38755111]

Grants

  1. RC2024/ministry of health

Word Cloud

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