Comparative analysis of the course of COVID-19 and post-COVID syndrome in patients with inflammatory bowel disease and COVID-19 caused by the Omicron strain and earlier strains

Abstract

BACKGROUND: Patients with inflammatory bowel disease have specific features of the course of COVID-19 and post-COVID syndrome. The available literature is limited in data comparing the course of COVID-19 of different strains in patients with inflammatory bowel disease as well as assessing the course of post-COVID syndrome.

AIM: To conduct a comparative analysis of the course of COVID-19 and post-covid syndrome in patients with inflammatory bowel disease and COVID-19 caused by the Omicron strain and earlier strains.

MATERIALS AND METHODS: The study included 159 patients diagnosed with ulcerative colitis and Crohn’s disease and COVID-19, who were observed in two temporary infectious diseases hospitals in Kazan (Republican Clinical Hospital and City Clinical Hospital No. 7) and on outpatient basis since April 2020 to May 2022. For a comparative analysis of the course of COVID-19 and post-COVID syndrome in patients who had come through COVID-19, 2 periods were defined: the 1st period — from March 2020 to December 2021, the 2nd period — from January 2022.

RESULTS: None of the patients with Omicron developed lung damage (0 (0%) vs 36 (44.4%), p < 0.05). It has been also found that among patients with Omicron there were more patients with comorbidity (62 (79.5%) versus 50 (61.7%), (p < 0.05).

Dynamic observation of the patients has revealed that post-covid syndrome was significantly less common in the patients with Omicron for 3 months after COVID-19 (25.6% vs. 47.1%).

When analyzing the complaints associated with asthenia, it was found that they were significantly more common in the patients with Omicron 3 months after COVID-19 (58 (74.3%) in comparison with 17 (50%), p < 0.05). The complaints associated with cognitive impairment (0 (0%) vs. 3 (8.8%), p < 0.05) and depression (Hospital Anxiety and Depression Scale (31 (39.7%) vs. 22 (64.7%), p < 0.05), Hamilton scale (22 (28.2%) vs. 22 (64.7%), p < 0.05)) were significantly less common in the patients with Omicron for 3 months after COVID-19.

After analyzing the activity in the patients with inflammatory bowel disease before COVID-19 and 3, 6, 9 months after COVID-19, we have found that the maximum number of patients with the exacerbation of inflammatory bowel disease was noted after 3 months in the patients with Omicron and after 6 months in the patients with earlier strains.

CONCLUSIONS: Thus, the results of the study have shown that in the patients with inflammatory bowel disease, both in ulcerative colitis and Crohn’s disease, the course of COVID-19 caused by the Omicron strain proceeded in a milder form compared with the patients who had earlier strains. In the patients with Omicron, complaints characteristic of post-COVID syndrome were less common. After a previous infection with COVID-19, the frequency of inflammatory bowel disease relapses increased: in the patients with Omicron due to mild exacerbation 3 months after COVID-19; in the patients with earlier strains — due to moderate and severe relapse.

Keywords

inflammatory bowel disease / COVID-19 / post-COVID syndrome / Omicron

References

[1] Hu J, Peng P, Cao X, et al. Increased immune escape of the new SARS-CoV-2 variant of concern Omicron. Cell Mol Immunol. 2022;19(2):293–295. DOI: 10.1038/s41423-021-00836-z

[2] Hu J., Peng P., Cao X. et al. Increased immune escape of the new SARS-CoV-2 variant of concern Omicron // Cell. Mol. Immunol. 2022. Vol. 19, No. 2. P. 293–295. DOI: 10.1038/s41423-021-00836-z

[3] Statistika rasprostraneniya shtammov COVID-19 [Internet]. Available from: https://yandex.ru/covid19/stat?ysclid=lailguacx3698961331. Accessed: 14.11.2022. (In Russ.)

[4] Статистика распространения штаммов COVID-19 [Электронный ресурс]. Режим доступа: https://yandex.ru/covid19/stat?ysclid=lailguacx3698961331. Дата обращения: 14.11.2022.

[5] Wolter N, Jassat W, Walaza S, et al. Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study. Lancet. 2022;399(10323):437–446. DOI: 10.1016/S0140-6736(22)00017-4

[6] Wolter N., Jassat W., Walaza S. et al. Early assessment of the clinical severity of the SARS-CoV-2 omicron variant in South Africa: a data linkage study // Lancet. 2022. Vol. 399, No. 10323. P. 437–446. DOI: 10.1016/S0140-6736(22)00017-4

[7] Maslo C, Friedland R, Toubkin M, et al. Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 Omicron wave compared with previous waves. JAMA. 2022;327(6):583–584. DOI: 10.1001/jama.2021.24868

[8] Maslo C., Friedland R., Toubkin M. et al. Characteristics and outcomes of hospitalized patients in South Africa during the COVID-19 Omicron wave compared with previous waves // JAMA. 2022. Vol. 327, No. 6. P. 583–584. DOI: 10.1001/jama.2021.24868

[9] Houhamdi L, Gautret P, Hoang VT, et al. Characteristics of the first 1119 SARS-CoV-2 Omicron variant cases, in Marseille, France, November-December 2021. J Med Virol. 2022;94(5):2290–2295. DOI: 10.1002/jmv.27613

[10] Houhamdi L., Gautret P., Hoang V.T. et al. Characteristics of the first 1119 SARS-CoV-2 Omicron variant cases, in Marseille, France, November-December 2021 // J. Med. Virol. 2022. Vol. 94, No. 5. P. 2290–2295. DOI: 10.1002/jmv.27613

[11] Menni C, Valdes AM, Polidori L, et al. Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study. Lancet. 2022;399(10335):1618–1624. DOI: 10.1016/S0140-6736(22)00327-0

[12] Menni C., Valdes A.M., Polidori L. et al. Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study // Lancet. 2022. Vol. 399, No. 10335. P. 1618–1624. DOI: 10.1016/S0140-6736(22)00327-0

[13] Macaluso FS, Giuliano A, Fries W, et al. Severe activity of inflammatory bowel disease is a risk factor for severe COVID-19. Inflamm Bowel Dis. 2023;29(2):217–221. DOI: 10.1093/ibd/izac064

[14] Macaluso F.S., Giuliano A., Fries W. et al. Severe activity of inflammatory bowel disease is a risk factor for severe COVID-19 // Inflamm. Bowel Dis. 2023. Vol. 29, No. 2. P. 217–221. DOI: 10.1093/ibd/izac064

[15] Lin S, Lau LH, Chanchlani N, et al. Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic. Gut. 2022;71(7):1426–1439. DOI: 10.1136/gutjnl-2021-326784

[16] Lin S., Lau L.H., Chanchlani N. et al. Recent advances in clinical practice: management of inflammatory bowel disease during the COVID-19 pandemic // Gut. 2022. Vol. 71, No. 7. P. 1426–1439. DOI: 10.1136/gutjnl-2021-326784

[17] Esposito S, Caminiti C, Giordano R, et al. Risks of SARS-CoV-2 infection and immune response to COVID-19 vaccines in patients with inflammatory bowel disease: current evidence. Front Immunol. 2022;13:933774. DOI: 10.3389/fimmu.2022.933774

[18] Esposito S., Caminiti C., Giordano R. et al. Risks of SARS-CoV-2 infection and immune response to COVID-19 vaccines in patients with inflammatory bowel disease: current evidence // Front. Immunol. 2022. Vol. 13. P. 933774. DOI: 10.3389/fimmu.2022.933774

[19] Briko NI, Korshunov VA, Krasnova SV, et al. Clinical and epidemiological characteristics of hospitalized patients with COVID-19 during different pandemic periods in Moscow. Journal of microbiology, epidemiology and immunobiology. 2022;99(3):287–299. (In Russ.) DOI: 10.36233/0372-9311-272

[20] Брико Н.И., Коршунов В.А., Краснова С.В. и др. Клинико-эпидемиологические особенности пациентов, госпитализированных с COVID-19 в различные периоды пандемии в Москве // Журнал микробиологии, эпидемиологии и иммунобиологии. 2022. Т. 99, № 3. С. 287–299. DOI: 10.36233/0372-9311-272

[21] Rasprostranenie COVID-19 v Respublike Tatarstan po dannym Rospotrebnadzora [Internet]. Available from: https://16.rospotrebnadzor.ru/?ysclid=lbluw2ffhr135904308. Accessed: 20.12.2022. (In Russ.)

[22] Распространение COVID-19 в Республике Татарстан по данным Роспотребнадзора [Электронный ресурс]. Режим доступа: https://16.rospotrebnadzor.ru/?ysclid=lbluw2ffhr135904308. Дата обращения: 20.12.2022.

[23] Best WR, Becktel JM, Singleton JW, Kern F Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study. Gastroenterology. 1976;70(3):439–444.

[24] Best W.R., Becktel J.M., Singleton J.W., Kern F. Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s Disease Study // Gastroenterology. 1976. Vol. 70, No. 3. P. 439–444.

[25] Truelove SC, Witts LJ. Cortisone in ulcerative colitis; preliminary report on a therapeutic trial. Br Med J. 1954;(2):375–378. DOI: 10.1136/bmj.2.4884.375

[26] Truelove S.C., Witts L.J. Cortisone in ulcerative colitis; preliminary report on a therapeutic trial // Br. Med. J. 1954. No. 2. P. 375–378. DOI: 10.1136/bmj.2.4884.375

[27] Prikaz Ministerstva zdravookhraneniya Rossiiskoi Federatsii ot 01.07.2021 № 698n “Ob utverzhdenii Poryadka napravleniya grazhdan na prokhozhdenie uglublennoi dispanserizatsii, vklyuchaya kategorii grazhdan, prokhodyashchikh uglublennuyu dispanserizatsiyu v pervoocherednom poryadke”. (In Russ.)

[28] Приказ Министерства здравоохранения Российской Федерации от 01.07.2021 № 698н «Об утверждении Порядка направления граждан на прохождение углубленной диспансеризации, включая категории граждан, проходящих углубленную диспансеризацию в первоочередном порядке».

[29] Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–370. DOI: 10.1111/j.1600-0447.1983.tb09716.x

[30] Zigmond A.S., Snaith R.P. The hospital anxiety and depression scale // Acta Psychiatr. Scand. 1983. Vol. 67, No. 6. P. 361–370. DOI: 10.1111/j.1600-0447.1983.tb09716.x

[31] The Hamilton rating scale for depression [Internet]. Available from: https://web.archive.org/web/20071120002356/http://healthnet.umassmed.edu/mhealth/HAMD.pdf. Accessed: 13.11.2022.

[32] The Hamilton rating scale for depression [Электронный ресурс]. Режим доступа: https://web.archive.org/web/20071120002356/http://healthnet.umassmed.edu/mhealth/HAMD.pdf. Дата обращения: 13.11.2022.

[33] Zolotovskaia IA, Shatskaia PR, Davydkin IL, Shavlovskaya OA. Post-COVID-19 asthenic syndrome. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(4):25–30. (In Russ.) DOI: 10.17116/jnevro202112104125

[34] Золотовская И.А., Шацкая П.Р., Давыдкин И.Л., Шавловская О.А. Астенический синдром у пациентов, перенесших COVID-19 // Журнал неврологии и психиатрии им. С.С. Корсакова. 2021. Т. 121, № 4. С. 25–30. DOI: 10.17116/jnevro202112104125

[35] Finney GR, Minagar A, Heilman KM. Assessment of mental status. Neurol Clin. 2016;34(1):1–16. DOI: 10.1016/j.ncl.2015.08.001

[36] Finney G.R, Minagar A., Heilman K.M. Assessment of mental status // Neurol. Clin. 2016. Vol. 34, No. 1. P. 1–16. DOI: 10.1016/j.ncl.2015.08.001

RIGHTS & PERMISSIONS

Eco-Vector