免疫抑制者罹患 COVID-19 并发症的风险较高，但在炎症性肠病（IBD）患者中的数据有限。我们评估了大型 IBD 患者队列中药物利用与 COVID-19 严重后遗症的风险。我们进行了一项回顾性队列研究，利用 2019 年 8 月 31 日至 2021 年 8 月 31 日的保险索赔数据。我们纳入了通过诊断和治疗代码确认的 IBD 患者。IBD 药物使用定义为入组前 90 天内的使用。研究结果包括 COVID-19 住院、机械通气和住院死亡。患者随访直至感兴趣的结果、门诊死亡、退保或研究结束。由于可用数据的聚合性质，我们无法进行多变量分析。我们纳入了 102,986 名患者（48,728 例 CD，47,592 例 UC），平均年龄为 53 岁；其中 55% 为女性。总体上，412 (0.4%) 名患者因 COVID-19 被住院。患者接受皮质类固醇的住院发生率更高（0.6% vs 0.3%；P < .0001；1000 人年内发生率为 13.6，95% 置信区间 [CI] 为 10.8-16.9），接受抗肿瘤坏死因子 α 治疗的住院发生率更低（0.2% vs 0.5%；P < .0001；1000 人年内发生率为 3.9，95% CI 为 2.7-5.4）。年龄越大，COVID-19 住院发生率越高。总体上，71 (0.07%) 名患者需要机械通气，52 (0.05%) 名患者在住院期间因 COVID-19 死亡。使用皮质类固醇的患者机械通气的比例更高（1.9% vs 0.05%；P < .0001；1000 人年内发生率为 3.9，95% CI 为 2.5-5.9）。在 IBD 患者中，使用皮质类固醇的患者在 COVID-19 中出现的住院和机械通气情况较多。抗肿瘤坏死因子 α 治疗与住院风险降低相关。这些发现加强了先前关于在 IBD 中逐渐减少和/或停用皮质类固醇的指导。© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Immunosuppressed individuals are at higher risk for COVID-19 complications, yet data in patients with inflammatory bowel disease (IBD) are limited. We evaluated the risk of COVID-19- severe sequelae by medication utilization in a large cohort of patients with IBD.We conducted a retrospective cohort study utilizing insurance claims data between August 31, 2019, and August 31, 2021.We included IBD patients identified by diagnosis and treatment codes. Use of IBD medications was defined in the 90 days prior to cohort entry. Study outcomes included COVID-19 hospitalization, mechanical ventilation, and inpatient death. Patients were followed until the outcome of interest, outpatient death, disenrollment, or end of study period. Due to the aggregate nature of available data, we were unable to perform multivariate analyses.We included 102 986 patients (48 728 CD, 47 592 UC) with a mean age of 53 years; 55% were female. Overall, 412 (0.4%) patients were hospitalized with COVID-19. The incidence of hospitalization was higher in those on corticosteroids (0.6% vs 0.3%; P < .0001; 13.6 per 1000 person-years; 95% confidence interval [CI], 10.8-16.9) and lower in those receiving anti-tumor necrosis factor α therapy (0.2% vs 0.5%; P < .0001; 3.9 per 1000 person-years; 95% CI, 2.7-5.4). Older age was associated with increased hospitalization with COVID-19. Overall, 71 (0.07%) patients required mechanical ventilation and 52 (0.05%) died at the hospital with COVID-19. The proportion requiring mechanical ventilation (1.9% vs 0.05%; P < .0001; 3.9 per 1000 person-years; 95% CI, 2.5-5.9) was higher among users of corticosteroids.Among patients with IBD, those on corticosteroids had more hospitalizations and mechanical ventilation with COVID-19. Anti-tumor necrosis factor α therapy was associated with a decreased risk of hospitalization. These findings reinforce previous guidance to taper and/or discontinue corticosteroids in IBD.© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.