Prevalence and outcomes of COVID-19 among patients with inflammatory bowel disease - A Danish prospective population-based cohort study.

BACKGROUND AND AIMS: As no population-based study has investigated the susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases (IBD), we aimed to investigate this topic in a population-based setting METHODS: Two cohorts were investigated First, a nationwide cohort of all IBD patients diagnosed with COVID-19 was prospectively followed to investigate the disease courses of both diseases Second, within a population-based cohort of 2 6 million Danish citizens, we identified all individuals tested for SARS-CoV-2 to determine the occurrence of COVID-19 among patients with and without IBD and other immune-mediated inflammatory diseases (IMIDs) RESULTS: Between January 28, 2020 and June 2, 2020, a total of 76 IBD patients with COVID-19 were identified in the national cohort and prospectively followed for 35 days (interquartile range (IQR): 25-51) A large proportion (n=19;25%) required a COVID-19-related hospitalization for seven days (IQR: 2-8 5) which was associated with being 65 years or older (odds ratio (OR)=23 80 (95% confidence interval (CI) 6 32-89 63), p<0 01) and presence of any non-IMID comorbidity (OR=8 12 (95% CI 2 55-25 87), p<0 01), but not use of immunomodulators (p=0 52) or biologic therapies (p=0 14) In the population-based study, 8,476 of 231,601 (3 7%) residents tested positive for SARS-CoV-2;however, the occurrence was significantly lower among patients with IBD (62 of the 2,486 patients=2 5%, p<0 01) and other IMIDs (531 of 16,492 patients=3 2%, p<0 01) as compared to patients without IMIDs CONCLUSION: Patients with IMIDs, including IBD, had a significantly lower susceptibility to COVID-19 than patients without IMIDs and neither immunosuppressive therapies nor IBD activity were associated with the disease course of COVID-19