The impact of
COVID-19 on
inflammatory bowel disease (IBD) patients under pharmacological immunosuppression is still not clearly understood. We investigated the incidence of
COVID-19 and the impact of immunosuppression and containment measures on the risk of
SARS-CoV-2 infection in a large IBD cohort, from a multicenter cohort from 21st of February to 30th of June, 2020. Ninety-seven patients with IBD (43 UC, 53 CD, one unclassified IBD) and concomitant
COVID-19 over a total of 23,879 patients with IBD were enrolled in the study. The cumulative incidence of
SARS-CoV-2 infection in patients with IBD vs. the general population was 0.406% and 0.402% cases, respectively. Twenty-three patients (24%) were hospitalized, 21 (22%) had
pneumonia, four (4%) were admitted to the Intensive Care Unit, and one patient died. Lethality in our cohort was 1% compared to 9% in the general population. At multivariable analysis, age > 65 years was associated with increased risk of
pneumonia and hospitalization (OR 11.6, 95% CI 2.18-62.60; OR 5.1, 95% CI 1.10-23.86, respectively), treatment with
corticosteroids increased the risk of hospitalization (OR 7.6, 95% CI 1.48-40.05), whereas
monoclonal antibodies were associated with reduced risk of
pneumonia and hospitalization (OR 0.1, 95% CI 0.04-0.52; OR 0.3, 95% CI 0.10-0.90, respectively). The risk of
COVID-19 in patients with IBD is similar to the general population. National lockdown was effective in preventing
infection in our cohort. Advanced age and treatment with
corticosteroids impacted negatively on the outcome of
COVID-19, whereas
monoclonal antibodies did not seem to have a detrimental effect.