Ethan M.. Cohen, MD1, Ayowumi A.. Adekolu, MD1, Taylor M.. McCready, MPH2, Joshua Kirkpatrick, MD1, Katherine Shephard, MD1, Olanrewaju Adeniran, MD1, Alejandra Mendez, MD1, Kanith Farah, MD1, Jennifer Hadam-Veverka, MD1, Swapna Gayam, MD1 1West Virginia University, Morgantown, WV; 2NYU Grossman School of Medicine, New York, NY
Introduction: Recent studies have shown that people with ulcerative colitis (UC) and Crohn’s disease (CD) do not have an increased risk of experiencing severe COVID-19, but no studies have examined the impact of COVID-19 infection on the risk of IBD flares. This study evaluates the risk of a UCC or CD flare among patients who were diagnosed with COVID-19 and those who were not.
Methods: We conducted a population-based retrospective cohort study using the TriNetX platform. Adult patients aged ≥18 years old with a confirmed diagnosis of either UC or CD were included. In the intervention group, participants were included if they were found to have tested positive for COVID-19 after being diagnosed with UC or CD from March 1, 2020 to May 6, 2024. We excluded patients with diagnoses that require treatment with intravenous methylprednisolone (20 and 40 mg). Patients who were diagnosed with UC or CD and did not test positive for COVID-19 were matched with the intervention group using 1:1 propensity score matching (PSM) according to demographics.
Results: We found statistically significant evidence of an association between patients with either UC or CD that test positive for COVID-19 having an increased risk of an IBD flare compared to patients with UC or CD that did not test positive for COVID-19 if all PSM assumptions hold (OR 1.68; 95% CI 1.63-1.73). Before PSM, the intervention group with UC or CD and COVID-19 comprised 116,603 patients, while the control group without a COVID-19 diagnosis consisted of 345,428 patients. 116,591 patients were matched.
Discussion: In this nation-wide cohort study, we found that the risk of developing a flare of UC or CD was significantly higher in patients who had previously tested positive for COVID-19 compared to those that did not. While the physiology has not yet been determined, COVID-19 is an inflammatory condition that increases stress and can lead to an immunocompromised state. Data has shown that these factors can increase the likelihood of UC or CD flares in the general population, so one would expect the same to happen post-COVID-19. Given these findings, deliberate attention should be paid to UC or CD patients post-COVID-19 to identify and treat flares early.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Ethan Cohen indicated no relevant financial relationships.
Ayowumi Adekolu indicated no relevant financial relationships.
Taylor McCready indicated no relevant financial relationships.
Joshua Kirkpatrick indicated no relevant financial relationships.
Katherine Shephard indicated no relevant financial relationships.
Olanrewaju Adeniran indicated no relevant financial relationships.
Alejandra Mendez indicated no relevant financial relationships.
Kanith Farah indicated no relevant financial relationships.
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