Brenner EJ. “IBD-related care in the era of COVID-19: Pediatric update.” Presented at: Crohn’s and Colitis Congress. Jan. 21-24, 2020.
Treat IBD ‘first and foremost’ in children who contract COVID-19
Children with inflammatory bowel disease who contract COVID-19 generally have mild disease, according to study results.
In her presentation at Crohn’s and Colitis Congress, Erica J. Brenner, MD, from the University of North Carolina, said that her group’s findings show that in in this patient group, physicians should treat IBD “first and foremost.”
“The aims of this study were two define the impact of COVID-19 on children and adolescents with inflammatory bowel disease,” she said. “We wanted to evaluate associations between comorbidities, IBD characteristics, demographic characteristics and IBD treatment and COVID-19 outcomes.”
Researchers analyzed data from two databases, the SECURE-IBD and the COVID-19 database of the Pediatric IBD Porto group of the European Society for Pediatric Gastroenterology Hepatology and Nutrition, which both began in March 2020. They included all patients aged 18 years and younger through October 1, 2020.
The final analysis included 209 patients (46% girls; 66% Crohn’s disease). In the patient group, 59% were in remission, 22% had mild disease, 13% had moderate disease and 5% had severe disease at the time of infection. Most of the patients had no comorbidities other than IBD (89%).
Brenner said the outcomes among the patient group were “very reassuring,” with no deaths, 14 hospitalizations and two patients needing mechanical ventilation.
The researchers found that comorbid conditions (50% hospitalized vs. 12% not hospitalized; P < .01), moderate/sever IBD disease activity (64% vs. 15%; P < .01), gastrointestinal symptoms (71% vs. 19%; P < .01), steroid use (29% vs. 8%; P = .03) and sulfasalazine/mesalamine use (57% vs. 21%; P = .01) were associated with hospitalization.
Conversely, anti-TNF monotherapy was associated with decreased likelihood of hospitalization (P < .01).
Brenner said these findings are in line with preliminary COVID-19 guidance released last year on the treatment of pediatric patients with IBD.
“As in the general pediatric population, children who contract COVID-19 rarely develop severe illness, including Multisystem Inflammatory Syndrome in Children,” Brenner said. “It is generally safe for children with IBD to continue their medications during the pandemic. While corticosteroids can be used to treat relapses, they should really be weaned as soon as possible.”