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P636 The natural history of COVID-19 in patients with IBD: A nationwide study by the Hellenic Society for the Study of IBD.

Bamias, G.(1);Kokkotis, G.(1);Christodoulou, D.(2);Delis, V.(3);Gatopoulou, A.(4);Giouleme, O.(5);Kalantzis, C.(6);Kapsoritakis, A.(7);Karatzas, P.(8);Karmiris, K.(9);Katsanos, K.(2);Kevrekidou, P.(10);Mathou, N.(11);Michalopoulos, G.(12);Michopoulos, S.(13);Papaconstantinou, I.(14);Polymeros, D.(15);Potamianos, S.(7);Poulopoulos, G.(1);Protopappas, A.(16);Soufleris, K.(10);Theodoropoulou, A.(9);Triantafillidis, J.K.(17);Triantafyllou, K.(15);Tsiolakidou, G.(18);Tsironi, E.(19);Tzouvala, M.(20);Viazis, N.(21);Zacharopoulou, E.(20);Zampeli, E.(13);Papatheodoridis, G.(8);Mantzaris, G.J.(21);

(1)3rd Department of Internal Medicine- National and Kapodistrian University of Athens- Sotiria Hospital, GI Unit, Athens, Greece;(2)Department of Internal Medicine University Hospital of Ioannina, Department of Gastroenterology, Ioannina, Greece;(3)General Hospital of Athens, Department of Gastroenterology- Hepatology and Gastrointestinal Endoscopy Unit, Athens, Greece;(4)General University Hospital of Alexandroupolis, 2nd Department of Internal Medicine, Alexandroupolis, Greece;(5)Hippocration Hospital- Aristotle University School of Medicine, 2nd Propedeutic Department of Internal Medicine, Thessaloniki, Greece;(6)Army Share Fund Hospital NIMTS, Department of Gastroenterology, Athens, Greece;(7)University Hospital of Thessaly, Department of Gastroenterology, Larissa, Greece;(8)Laiko General Hospital- Medical School of National and Kapodistrian University of Athens, Department of Gastroenterology, Athens, Greece;(9)Venizeleio General Hospital, Department of Gastroenterology, Heraklion, Greece;(10)Theageneio Cancer Hospital of Thessaloniki, Department of Gastroenterology, Thessaloniki, Greece;(11)“Konstantopoulio-Patission" General Hospital, Department of Gastroenterology, Athens, Greece;(12)Tzaneion General Hospital, Department of Gastroenterology, Piraeus, Greece;(13)Alexandra General Hospital, Department of Gastroenterology, Athens, Greece;(14)National and Kapodistrian University of Athens- Medical School- Aretaieion University Hospital, Second Department of Surgery, Athens, Greece;(15)Second Dept of Internal Medicine-Propaedeutic- Medical School- National and Kapodistrian University of Athens- Attikon University General Hospital, Hepatogastroenterology Unit, Athens, Greece;(16)University General Hospital of Thessaloniki AHEPA, Department of Gastroenterology, Thessaloniki, Greece;(17)METROPOLITAN GENERAL" Hospital, Department of Gastroenterology, Athens, Greece;(18)General Hospital of Kavala, Department of Gastroenterology, Kavala, Greece;(19)Metaxa Memorial General Hospital, Department of Gastroenterology, Piraeus, Greece;(20)General Hospital Nikaias-Piraeus “Agios Panteleimon” -General Hospital Dytikis Attikis “Agia Varvara”, Department of Gastroenterology, Piraeus, Greece;(21)GHA Evaggelismos- Opthalmiatreion Athinon-Polykliniki, Department of Gastroenterology, Athens, Greece

Background

COVID-19 has evolved into a global health crisis, variably affecting the management of patients with chronic illnesses. Patients with inflammatory bowel disease (IBD) may represent a vulnerable population due to the frequent administration of immune-modifying treatments.

Methods

We aimed to depict the natural history of COVID-19 infection in Greek patients with IBD at a nationwide level via the unbiased reporting of all cases that were registered during the first and second waves of the pandemic. Following a national call from the Hellenic Society for the study of IBD, we enrolled all IBD patients with established diagnosis of COVID-19. Clinical and epidemiological data, including COVID-19 modifying factors and IBD-associated therapies were analysed against adverse outcomes (hospitalization, ICU admission, and death).

Results

We identified 80 patients with IBD who were diagnosed with COVID-19 during the study period (male:65%; median age=44 [IQR=26] years; CD:62.5%). Adverse outcomes were reported in 16 patients (20%), including 3 ICU admissions (3.75%) and 2 deaths (2.5%). Negative prognostic factors for adverse outcomes included age, Body Mass Index, and hypertension, as well as dyspnoea, fatigue and abdominal pain at presentation. In contrast, treatment with biologics, in particular anti-TNF agents, exerted a protective effect against an unfavorable course COVID-19. Patients on subcutaneous biologics were more likely to halt treatment due to the infection as compared to those on intravenous medications.

Conclusion

Patients with IBD who developed COVID-19 had a benign course with adverse outcomes being scarce. Treatment with biologics had a beneficial effect, supporting the continuation of therapy during the pandemic.

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