SynthesisArquivos de gastroenterologia2026
COVID-19 AND IBD: LOOK BEYOND THE VIRUS. A SYSTEMATIC REVIEW AND META-ANALYSIS FOCUSED ON BIOLOGIC THERAPY CONTINUITY.
Synthesis in Arquivos de gastroenterologia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
BACKGROUND/
objectiveWhether COVID-19 worsens the longterm course of inflammatory bowel disease (IBD) remains uncertain. We synthesized comparative cohorts to assess IBD outcomes after SARS-CoV-2 infection versus noninfected IBD controls and to evaluate the impact of biologic discontinuation.
methodsSystematic review (PRISMA 2020). Adult IBD cohorts with vs without prior SARS-CoV-2. Databases: MEDLINE (PubMed), Web of Science, and Scopus; reference lists screened. Time window: Jan 2020 to Dec 2024. Risk of bias: Newcastle-Ottawa. Randomeffects Mantel-Haenszel with REML variance and Hartung-Knapp adjustment; heterogeneity by I2/τ2/Q. Zero events handled via 0.5 continuity correction; sensitivity analyses reported risk differences (percentage points) and studylevel effects for sparse outcomes. Certainty graded with GRADE.
resultsFour matched cohorts (n≈1.3k; Italy/USA). Prior SARS-CoV-2 did not worsen IBD clinical course (OR: 1.06; 95%CI: 0.76-1.49), nor alter UC extent (OR: 1.26; 95%CI: 0.33-4.83) or CD location/behavior (OR: 1.00; 95%CI: 0.06-16.15 / OR: 1.00; 95%CI: 0.46-2.18). Conversely, COVID-19 associated with biologic delay/discontinuation (OR: 10.44; 95%CI: 3.56-30.62). Across studies, flares were more frequent when biologics were delayed/stopped (~52% vs ~18%; RD ≈ +34 p.p.).
conclusionCOVID-19 per se does not appear to aggravate IBD outcomes; the clinically actionable signal is treatment continuity. In IBD patients without highrisk features for severe COVID-19, maintaining biologics should be considered to prevent flares.
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