Inflammatory bowel disease and risk of severe COVID-19: A nationwide population-based cohort study in Sweden

AbstractBackgroundThere are concerns that individuals with chronic immune-mediated diseases are at increased risk of COVID-19 and related severe adverse outcome, including intensive care admission or death We aimed to explore the absolute and relative risk of severe COVID-19 in inflammatory bowel disease (IBD) MethodsThis population-based cohort study used nationwide registers in Sweden, with 67,292 individuals with a diagnosis of IBD 1969-2017 (Crohn?s disease, n=21,599;ulcerative colitis: n=43,622;IBD-unclassified: n=2,071) and alive on February 1, 2020 Patients with IBD were matched to up to 5 controls from the general population (n=297,910) Cox regression estimated hazard ratios (HRs) for (I) hospital admission with laboratory-confirmed COVID-19 as the primary diagnosis, and (II) severe COVID-19 (composite outcome consisting of (a) COVID-19 intensive care admission, or (b) death from COVID-19 or (c) death within 30 days of COVID-19 hospital admission), were calculated Analyses were conditioned on age, sex, calendar period, and county, and adjusted for other comorbidities ResultsBetween February 1 and July 31, 2020, 179 (0 27%) IBD patients and 500 (0 17%) general population controls were admitted to hospital with COVID-19 (adjusted HR (aHR)=1 43;95%CI=1 19-1 72) The corresponding numbers for severe COVID-19 was 65 (0 10%) and 183 (0 06%)(aHR=1 11;95%CI=0 81-1 52) Adjusted HRs were similar in Crohn?s disease and ulcerative colitis In a propensity score-matched model taking comorbidity into account until 2016, the increased risk for COVID-19 hospital admission remained (aHR=1 32;1 12-1 56), but there was no increased risk of severe COVID-19 (aHR=1 12;0 85-1 47) ConclusionsWhile individuals with IBD were more likely to be admitted to hospital for COVID-19 than the general population, the risk of severe COVID-19 was not higher This article is protected by copyright All rights reserved