PDF(Pubmed)
Abstract：
The Inflammatory Bowel Disease (IBD) patients have adopted lifestyle modifications to prevent infection via SARS COV-2.
This study aims to examine rate of serious infections and opportunistic infections in the pre-pandemic and pandemic period, and to analyse if the risk associated with medications used to treat IBD were potentially modified by associated change in lifestyle.
We conducted a retrospective cohort study of patients from the US national Veteran Affairs Healthcare System (VAHS). Patients were stratified into two groups: pre-pandemic (prior to SARS COV-2 pandemic) and pandemic (during SARS COV-2 pandemic) and outcomes were measured in these groups. Primary outcome was occurrence of any serious infection. Secondary outcome was occurrence of any opportunistic infection.
There were 17,202 IBD patients in the pre-pandemic era and 15,903 patients in the pandemic era. The pre-pandemic era had a significantly higher proportion of serious infections relative to the pandemic era (5.1% vs. 4.4%, p = 0.002). The proportion of opportunistic infections were similar between pre-pandemic and pandemic eras (0.3% vs. 0.3%, p = 0.82). Relative to 5-ASA, patients taking anti-TNF (HR = 1.50 (1.31-1.72)), anti-TNF+TP (HR = 1.56 (1.24-1.95)) or vedolizumab (HR = 1.81 (1.49-2.20)) had an increased hazard of serious infection (p > 0.001).
In a nationwide cohort of IBD patients, we found that risk of serious infections could possibly be affected by behavioural modifications due to SARS-COV-2 pandemic.
This study aims to examine rate of serious infections and opportunistic infections in the pre-pandemic and pandemic period, and to analyse if the risk associated with medications used to treat IBD were potentially modified by associated change in lifestyle.
We conducted a retrospective cohort study of patients from the US national Veteran Affairs Healthcare System (VAHS). Patients were stratified into two groups: pre-pandemic (prior to SARS COV-2 pandemic) and pandemic (during SARS COV-2 pandemic) and outcomes were measured in these groups. Primary outcome was occurrence of any serious infection. Secondary outcome was occurrence of any opportunistic infection.
There were 17,202 IBD patients in the pre-pandemic era and 15,903 patients in the pandemic era. The pre-pandemic era had a significantly higher proportion of serious infections relative to the pandemic era (5.1% vs. 4.4%, p = 0.002). The proportion of opportunistic infections were similar between pre-pandemic and pandemic eras (0.3% vs. 0.3%, p = 0.82). Relative to 5-ASA, patients taking anti-TNF (HR = 1.50 (1.31-1.72)), anti-TNF+TP (HR = 1.56 (1.24-1.95)) or vedolizumab (HR = 1.81 (1.49-2.20)) had an increased hazard of serious infection (p > 0.001).
In a nationwide cohort of IBD patients, we found that risk of serious infections could possibly be affected by behavioural modifications due to SARS-COV-2 pandemic.
摘要：
背景：炎症性肠病（IBD）患者已通过改变生活方式来预防SARSCOV-2感染。
目的：本研究旨在检查大流行前和大流行期间严重感染和机会性感染的发生率，并分析与用于治疗IBD的药物相关的风险是否可能因相关生活方式的改变而有所改变.
方法：我们对来自美国国家退伍军人事务医疗保健系统（VAHS）的患者进行了一项回顾性队列研究。将患者分为两组：大流行前（SARSCOV-2大流行之前）和大流行（SARSCOV-2大流行期间），并在这些组中测量结果。主要结果是发生任何严重感染。次要结果是发生任何机会性感染。
结果：大流行前时代有17,202名IBD患者，大流行时代有15,903名患者。大流行前时代的严重感染比例明显高于大流行时代(5.1%vs.4.4%,p=0.002)。大流行前和大流行时期的机会性感染比例相似(0.3%与0.3%,p=0.82）。相对于5-ASA，服用抗TNF的患者（HR=1.50（1.31-1.72）），抗TNF+TP(HR=1.56(1.24-1.95))或维多珠单抗(HR=1.81(1.49-2.20))发生严重感染的风险增加(p>0.001).
结论：在全国范围的IBD患者队列中，我们发现,SARS-COV-2大流行导致的行为改变可能会影响严重感染的风险.
目的：本研究旨在检查大流行前和大流行期间严重感染和机会性感染的发生率，并分析与用于治疗IBD的药物相关的风险是否可能因相关生活方式的改变而有所改变.
方法：我们对来自美国国家退伍军人事务医疗保健系统（VAHS）的患者进行了一项回顾性队列研究。将患者分为两组：大流行前（SARSCOV-2大流行之前）和大流行（SARSCOV-2大流行期间），并在这些组中测量结果。主要结果是发生任何严重感染。次要结果是发生任何机会性感染。
结果：大流行前时代有17,202名IBD患者，大流行时代有15,903名患者。大流行前时代的严重感染比例明显高于大流行时代(5.1%vs.4.4%,p=0.002)。大流行前和大流行时期的机会性感染比例相似(0.3%与0.3%,p=0.82）。相对于5-ASA，服用抗TNF的患者（HR=1.50（1.31-1.72）），抗TNF+TP(HR=1.56(1.24-1.95))或维多珠单抗(HR=1.81(1.49-2.20))发生严重感染的风险增加(p>0.001).
结论：在全国范围的IBD患者队列中，我们发现,SARS-COV-2大流行导致的行为改变可能会影响严重感染的风险.
