COVID-19 Does Not Lead to Increase in Corticosteroid Use in IBD

COVID-19 infection does not lead to increased corticosteroid prescriptions in patients with inflammatory bowel disease (IBD), according to a new study published in Inflammatory Bowel Diseases.

Researchers used data from the Danish National Patient Registry (NPR), the Nationwide Prescription Database, the Danish Department of Clinical Microbiology and Statens Serum Institut, and the Danish Civil Registration System. Patients included in the study had at least 1 diagnosis of ulcerative colitis (UC) or Crohn disease (CD). UC and CD were identified via ICD-10 codes. Study participants in the cohort also had a positive COVID-19 PCR test between March 1, 2020 and July 31, 2022, and survived at least 6 months after a positive PCR test.

A total of 30,102 patients with IBD and positive COVID-19 PCR tests were included in the study; 37.1% (n=11,159) had CD, and 62.9% (n=18,943) had UC. A total of 4.3% of the patients had 1 or more corticosteroid prescriptions 6 months prior to the positive test, and 4.0% of the patients had 1 or more corticosteroid prescriptions after a positive COVID-19 test. The crude and adjusted incidence rate ratios for getting a corticosteroid prescription after a COVID-19 positive test in patients with IBD were 0.98 (95% CI, 0.90-1.07) and 0.98 (95% CI, 0.90-1.07), respectively. When the investigators performed a subanalysis requiring at least 2 diagnoses of UC or CD rather than just 1, the results did not change. They also performed subanalyses stratifying the data according to calendar periods and patient age but did not find significantly different results.

Study limitations include not having all the clinical data for patients, such as the extent of bowel involvement of the IBD, clinical score of disease activity, smoking habits, or BMI. Factors such as these could have confounded the study. Researchers also did not have detailed information about the corticosteroid prescriptions, including doses or the length of treatment.

“[A]n infection with COVID-19 did not result in a higher rate of filled corticosteroid prescriptions in a nationwide population of patients with IBD,” the study authors wrote. “Based on this finding, COVID-19 did not seem to trigger disease activity in IBD patients, which is a reassuring result for patients with IBD.”

This article originally appeared on Gastroenterology Advisor