Table 3.
Factors associated with short-term clinical relapse in ulcerative colitis and Crohn’s disease following COVID-19
| Ulcerative colitis [univariate analysis] | Crohn’s disease [univariate analysis] | Crohn’s disease [multivariate analysis] | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | ||
| Female gender | 0.61 | 0.23–1.50 | 0.29 | 0.64 | 0.26–1.59 | 0.33 | ||||
| Age >50 years | 0.29 | 0.34–2.09 | 0.74 | 1.37 | 0.55–3.35 | 0.48 | ||||
| Age >60 years | 1.18 | 0.41–3.04 | 0.73 | 1.03 | 0.32–2.81 | 0.94 | ||||
| Age >70 years | 0.88 | 0.20–2.74 | 0.84 | 1.27 | 0.28–4.19 | 0.71 | ||||
| Body mass index >25 | 0.54 | 0.08–2.02 | 0.43 | 1.47 | 0.48–4.07 | 0.46 | ||||
| Smoking at the time of COVID-19 | 2.01 | 0.75–5.66 | 0.16 | 0.71 | 0.27–1.80 | 0.48 | ||||
| Disease activity of IBD at diagnosis of COVID-19 | ||||||||||
| Clinical remission | 1.20 | 0.48–3.26 | 0.69 | 0.62 | 0.25–1.52 | 0.30 | ||||
| Biochemical remission | 1.84 | 0.74–4.98 | 0.19 | 0.88 | 0.35–2.16 | 0.78 | ||||
| Endoscopic remission | 0.69 | 0.10–2.53 | 0.63 | 1.15 | 0.25–3.77 | 0.82 | ||||
| Phenotype of IBD | ||||||||||
| E1: ulcerative proctitis | 1.46 | 0.50–3.77 | 0.44 | L1: ileal disease | 0.99 | 0.31–2.69 | 0.98 | |||
| E2: left-sided UC | 0.85 | 0.29–2.18 | 0.76 | L2: colonic disease | 1.43 | 0.56–3.52 | 0.43 | |||
| E3: extensive colitis | 1.21 | 0.42–3.11 | 0.69 | L3: ileocolonic disease | 1.04 | 0.38–2.63 | 0.92 | |||
| L4: upper gastrointestinal disease | 6.75 | 1.25–32.90 | 0.01 | 10.57 | 1.89–54.15 | <0.01 | ||||
| B1: non-stricturing, non-penetrating | 1.16 | 0.47–3.05 | 0.74 | |||||||
| B2: stricturing | 1.62 | 0.43–4.88 | 0.41 | |||||||
| B3: penetrating | 0.87 | 0.04–5.02 | 0.90 | |||||||
| Perianal disease | ||||||||||
| Comorbidities other than IMIDs | 1.85 | 0.73–4.54 | 0.17 | 1.20 | 0.43–3.03 | 0.70 | ||||
| IMIDs | 1.32 | 0.36–3.78 | 0.62 | 1.54 | 0.47–4.27 | 0.42 | ||||
| IBD-related treatment | ||||||||||
| Topical 5-ASA | 1.34 | 0.49–3.35 | 0.53 | NA | ||||||
| Systemic 5-ASA | 1.01 | 0.40–2.47 | 0.97 | NA | ||||||
| Topical steroids | NA | NA | ||||||||
| Systemic steroids | 1.30 | 0.06–7.26 | 0.80 | 2.81 | 0.39–13.20 | 0.22 | ||||
| Immunomodulators | 0.68 | 0.10–2.47 | 0.61 | 1.65 | 0.62–4.12 | 0.29 | ||||
| Azathioprine | 1.01 | 0.15–3.76 | 0.98 | 1.39 | 0.47–3.66 | 0.51 | ||||
| Methotrexate | NA | 2.03 | 0.10–14.58 | 0.53 | ||||||
| Biologic therapy | 1.11 | 0.25–3.47 | 0.87 | 1.37 | 0.55–3.36 | 0.48 | ||||
| Tumour necrosis factor antagonist | 0.48 | 0.02–2.46 | 0.48 | 1.15 | 0.39–2.99 | 0.78 | ||||
| Infliximab | 0.78 | 0.04–4.09 | 0.81 | 1.09 | 0.24–3.56 | 0.88 | ||||
| Adalimumab | NA | 1.09 | 0.24–3.56 | 0.88 | ||||||
| Vedolizumab | 1.44 | 0.07–8.12 | 0.73 | 0.50 | 0.02–2.71 | 0.52 | ||||
| Ustekinumab | 14.90 | 0.57–386.28 | 0.18 | 17.40 | 1.59–384.42 | 0.02 | 18.32 | 1.44–43.44 | 0.03 | |
| No treatment | 0.56 | 0.12–1.73 | 0.37 | 0.65 | 0.22–1.66 | 0.39 | ||||
| Discontinuation of immunosuppressive therapy | 0.94 | 0.05–5.05 | 0.95 | 3.98 | 0.81–15.39 | 0.07 | ||||
| Antidrug antibody formation | NA | NA | ||||||||
| Adverse COVID-19 | 0.99 | 0.22–3.09 | 0.99 | 4.33 | 1.49–11.91 | <0.01 | 5.11 | 1.64–15.12 | <0.01 | |
| Severe COVID-19 | NA | 4.11 | 0.18–44.80 | 0.25 | ||||||
IBD, inflammatory bowel disease; IMID, immune-mediated inflammatory disease; 5-ASA, 5-aminosalicylates; COVID-19, coronavirus disease 2019; NA, not applicable; OR, odds ratio. Localization of IBD is categorized according to the Montreal Classification. The p-values originate from regression analyses, and p < 0.05 [bold] was considered to be significant.