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. 2022 Apr 3;10(4):843.
doi: 10.3390/biomedicines10040843.

Impact of SARS-CoV-2 Infection on the Course of Inflammatory Bowel Disease in Patients Treated with Biological Therapeutic Agents: A Case-Control Study

Alfredo Papa  1   2 , Franco Scaldaferri  1   2 , Marcello Covino  2   3 , Antonio Tursi  4 , Federica Furfaro  5 , Giammarco Mocci  6 , Loris Riccardo Lopetuso  1   7   8 , Giovanni Maconi  9 , Stefano Bibbò  1 , Marcello Fiorani  1 , Lucrezia Laterza  1 , Irene Mignini  1 , Daniele Napolitano  1 , Laura Parisio  1 , Marco Pizzoferrato  1 , Giuseppe Privitera  1 , Daniela Pugliese  1 , Tommaso Schepis  1 , Elisa Schiavoni  1 , Carlo Romano Settanni  1 , Lorenzo Maria Vetrone  1 , Alessandro Armuzzi  1   2 , Silvio Danese  10 , Antonio Gasbarrini  1   2
Affiliations

Impact of SARS-CoV-2 Infection on the Course of Inflammatory Bowel Disease in Patients Treated with Biological Therapeutic Agents: A Case-Control Study

Alfredo Papa et al. Biomedicines. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has raised concerns in patients with inflammatory bowel disease (IBD), not only due to consequences of coronavirus disease 2019 itself but also as a possible cause of IBD relapse. The main objective of this study was to assess the role of SARS-CoV-2 in IBD clinical recurrence in a cohort of patients undergoing biological therapy. Second, we evaluated the difference in C-reactive protein (CRP) levels between the start and end of the follow-up period (ΔCRP) and the rate of biological therapy discontinuation. Patients with IBD positive for SARS-CoV-2 infection were compared with non-infected patients. IBD recurrence was defined as the need for intensification of current therapy. We enrolled 95 IBD patients with SARS-CoV-2 infection and 190 non-infected patients. During follow-up, 11 of 95 (11.6%) SARS-CoV-2-infected patients experienced disease recurrence compared to 21 of 190 (11.3%) in the control group (p = 0.894). Forty-six (48.4%) SARS-CoV-2-infected patients discontinued biological therapy versus seven (3.7%) in the control group (p < 0.01). In the multivariate analysis, biological agent discontinuation (p = 0.033) and ΔCRP (p = 0.017), but not SARS-CoV-2 infection (p = 0.298), were associated with IBD recurrence. SARS-CoV-2 infection was not associated with increased IBD recurrence rates in this cohort of patients treated with biological agents.

Keywords: SARS-CoV-2; biological agents; inflammatory bowel disease.

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Conflict of interest statement

F.F. served as a lecturer for Sanofi. G.M. served as a speaker for and/or received advisory board fees from Alfasigma, Arena Pharmaceuticals, Inc., Janssen Pharmaceuticals, Gilead Sciences, Inc., and Roche. G.P. received consulting fees from Alfasigma. D.P. received speaker fees from AbbVie, MSD, Takeda Pharmaceutical Company, Ltd., Janssen Pharmaceuticals, and Pfizer. A.A. received consulting and/or advisory board fees from AbbVie, Allergan, Amgen, Biogen, Bristol-Myers Squibb, Celgene, Celltrion, Ferring Pharmaceuticals, Janssen Pharmaceuticals, Eli Lilly and Company, MSD, Mylan, Pfizer, Samsung Bioepis, Sandoz, and Takeda Pharmaceutical Company, Ltd.; lecture and/or speaker bureau fees from AbbVie, Amgen, Biogen, Ferring, Janssen Pharmaceuticals, MSD, Mitsubishi Tanabe Pharma, Nikkiso Co., Ltd., Pfizer, Sandoz, Samsung Bioepis, and Takeda Pharmaceuticals; and research grants from MSD, Pfizer, and Takeda Pharmaceuticals. S.D. has served as a speaker, consultant, and advisory board member for Schering-Plough, AbbVie, Actelion, Alfa Wassermann, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring Pharmaceuticals, Genentech, Grünenthal, Johnson & Johnson, Millennium Takeda, MSD, Nikkiso Europe GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma, and Vifor Pharma. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Map of Italy depicting the locations of the centers included in the study: two in the north of Italy (Milan), one in the center (Rome), one in the south (Andria), and one in Sardinia (Cagliari).
Figure 2
Figure 2
The cumulative risk of IBD recurrence in patients with COVID-19 versus controls (non-infected patients with IBD). IBD, inflammatory bowel disease; COVID-19, coronavirus disease 2019.
See this image and copyright information in PMC

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