ABSTRACT Backgrounds: 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. Backgrounds Fortunately COVID19 COVID 19 COVID-1 IBD. . (IBD) COVID19. 19. However immunemediated immune mediated Objective population Methods tertiarycare tertiary care public Ceará Brazil 2020 Furthermore Results 51 23 CD 28 UC 17 34% 34 (34% possibleconfirmed 15 90% 90 (90% symptomatic 65% 65 (65% OR 171 1 71 1.71 95CI CI 95 1.172.50 117250 1.17 2.50 2 50 1.17-2.50) 507 5 07 5.07 3.317.78 331778 3.31 7.78 3 31 7 78 3.31-7.78 314 14 3.14 2.104.71 210471 2.10 4.71 10 4 2.10-4.71 187 87 1.87 1.262.78 126278 1.26 2.78 26 1.26-2.78) 229 29 2.29 1.583.33 158333 1.58 3.33 58 33 1.58-3.33 1.174.28 117428 4.28 1.17-4.28) 710 7.10 1.4634.57. 1463457 1.46 34.57 46 57 1.46-34.57) Conclusion association COVID1 COVID- (IBD 202 (34 9 (90 6 (65 1.7 172 1.172.5 11725 117 1.1 250 2.5 1.17-2.50 0 5.0 317 3.317.7 33177 331 3.3 778 7.7 3.31-7.7 3.1 104 2.104.7 21047 210 2.1 471 4.7 2.10-4.7 18 8 1.8 262 1.262.7 12627 126 1.2 278 2.7 1.26-2.78 22 2.2 583 1.583.3 15833 158 1.5 333 1.58-3.3 1.174.2 11742 428 4.2 1.17-4.28 7.1 4634 1.4634.57 146345 146 1.4 3457 34.5 1.46-34.57 20 (3 (9 (6 1. 1.172. 1172 11 25 2. 1.17-2.5 5. 3.317. 3317 3. 77 7. 3.31-7. 2.104. 2104 21 47 4. 2.10-4. 1.262. 1262 12 27 1.26-2.7 1.583. 1583 1.58-3. 1.174. 1174 42 1.17-4.2 463 1.4634.5 14634 345 34. 1.46-34.5 ( 1.172 1.17-2. 3.317 3.31-7 2.104 2.10-4 1.262 1.26-2. 1.583 1.58-3 1.174 1.17-4. 1.4634. 1463 1.46-34. 1.17-2 3.31- 2.10- 1.26-2 1.58- 1.17-4 1.4634 1.46-34 1.17- 1.26- 1.463 1.46-3 1.46-
RESUMO Contexto: Felizmente, muito se tem estudado sobre a COVID-19 em pacientes com doenças inflamatórias intestinais (DII). As evidências sugerem que esses pacientes não parecem ter risco aumentado de COVID-19 grave. Mas ainda se tem algumas incertezas com relação às manifestações clínicas da COVID-19 em portadores de doenças imunomediadas. Objetivo: Este estudo teve como objetivo descrever os principais sintomas da COVID-19 e sua frequência em pacientes com DII e avaliar o impacto dos medicamentos utilizados no tratamento das DII na apresentação clínica da COVID-19. Métodos: Pacientes adultos com DII de três hospitais públicos terciários de ensino do Ceará, Nordeste do Brasil, foram avaliados em consulta ambulatorial no período de março a dezembro de 2020. Pacientes com COVID-19 possível ou confirmada foram comparados com pacientes sem COVID-19. Além disso, as incidências de cada sintoma foram avaliadas com base no uso de medicamentos utilizados para tratamento da DII. Resultados: Foram incluídos no estudo 515 pacientes com DII: 234 com DC e 281 com RCU. Destes, 174 pacientes (34%) tinham COVID-19 possível/confirmado, dos quais 156 (90%) eram sintomáticos. Os principais sintomas foram febre (65%) e dor de cabeça (65%); sintomas gastrointestinais ocorreram em um terço dos pacientes, sendo mais frequentes do que na população geral com COVID-19. Os fatores associados a ter COVID-19 foram sexo feminino (OR 1,71, IC95%: 1,17-2,50); ter contato com caso de COVID-19, tanto intradomiciliar (OR 5,07; IC95%: 3,31-7,78) como fora do domicílio (OR 3,14; IC95%: 2,10-4,71); trabalhar fora de casa (OR 1,87; IC95%: 1,26-2,78); história familiar de COVID-19 (OR 2,29, IC95% 1,58-3,33), uso de salicilato (OR 1,71, IC95%: 1,17-4,28) e asma (OR 7,10; IC95%: 1,46-34,57). Conclusão: Pacientes com DII com alto risco de infecção por COVID-19 podem precisar evitar a terapia com salicilatos, mas mais estudos são necessários para confirmar esta associação. Contexto Felizmente COVID19 COVID 19 COVID-1 . (DII) grave imunomediadas Objetivo COVID19. 19. Métodos Ceará Brasil 2020 disso Resultados 51 23 28 RCU Destes 17 34% 34 (34% possívelconfirmado confirmado possível/confirmado 15 90% 90 (90% sintomáticos 65% 65 (65% OR 171 1 71 1,71 IC95 IC 1,172,50 117250 1,17 2,50 2 50 1,17-2,50) COVID19, 19, 5,07 507 5 07 3,317,78 331778 3,31 7,78 3 31 7 78 3,31-7,78 3,14 314 14 2,104,71 210471 2,10 4,71 10 4 2,10-4,71) 1,87 187 87 1,262,78 126278 1,26 2,78 26 1,26-2,78) 229 29 2,29 1,583,33, 158333 1,58 3,33 , 58 33 1,58-3,33) 1,174,28 117428 4,28 1,17-4,28 7,10 710 1,4634,57. 1463457 1,46 34,57 46 57 1,46-34,57) Conclusão salicilatos associação COVID1 COVID- (DII 202 (34 9 (90 6 (65 1,7 IC9 172 1,172,5 11725 117 1,1 250 2,5 1,17-2,50 5,0 0 317 3,317,7 33177 331 3,3 778 7,7 3,31-7,7 3,1 104 2,104,7 21047 210 2,1 471 4,7 2,10-4,71 1,8 18 8 262 1,262,7 12627 126 1,2 278 2,7 1,26-2,78 22 2,2 583 1,583,33 15833 158 1,5 333 1,58-3,33 1,174,2 11742 428 4,2 1,17-4,2 7,1 4634 1,4634,57 146345 146 1,4 3457 34,5 1,46-34,57 20 (3 (9 (6 1, 1,172, 1172 11 25 2, 1,17-2,5 5, 3,317, 3317 3, 77 7, 3,31-7, 2,104, 2104 21 47 4, 2,10-4,7 1,262, 1262 12 27 1,26-2,7 1,583,3 1583 1,58-3,3 1,174, 1174 42 1,17-4, 463 1,4634,5 14634 345 34, 1,46-34,5 ( 1,172 1,17-2, 3,317 3,31-7 2,104 2,10-4, 1,262 1,26-2, 1,583, 1,58-3, 1,174 1,17-4 1,4634, 1463 1,46-34, 1,17-2 3,31- 2,10-4 1,26-2 1,583 1,58-3 1,17- 1,4634 1,46-34 2,10- 1,26- 1,58- 1,463 1,46-3 1,46-