Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2021; 27(12): 1226-1239
Published online Mar 28, 2021. doi: 10.3748/wjg.v27.i12.1226
Risk stratification and geographical mapping of Brazilian inflammatory bowel disease patients during the COVID-19 outbreak: Results from a nationwide survey
Natália Sousa Freitas Queiroz, Fábio Vieira Teixeira, Marina Pamponet Motta, Liliana Andrade Chebli, Adriano Akira Ferreira Hino, Camilla de Almeida Martins, Abel Botelho Quaresma, Alexandre Augusto de Paula da Silva, Adérson Omar Mourão Cintra Damião, Rogerio Saad-Hossne, Paulo Gustavo Kotze
Natália Sousa Freitas Queiroz, Camilla de Almeida Martins, Adérson Omar Mourão Cintra Damião, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo 05403-000, SP, Brazil
Fábio Vieira Teixeira, IBD Unit, Gastroenterology Department, Gastrosaúde Clinic, Marilia 17509190, SP, Brazil
Marina Pamponet Motta, School of Medicine, Federal University of Bahia, Salvador 40020-025, BH, Brazil
Liliana Andrade Chebli, IBD Outpatient Clinics, Universidade Federal de Juiz de Fora, Juiz de Fora 36010-010, MG, Brazil
Adriano Akira Ferreira Hino, Alexandre Augusto de Paula da Silva, Paulo Gustavo Kotze, Health Sciences Postgraduate Program, Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba 80440-220, PR, Brazil
Abel Botelho Quaresma, Departamento de Ciências da Saúde, Universidade do Oeste de Santa Catarina (UNOESC), Joaçaba 89600-000, SC, Brazil
Rogerio Saad-Hossne, Botucatu Medical School, Paulista State University (UNESP), Botucatu 18600-050, SP, Brazil
Paulo Gustavo Kotze, IBD Outpatient Clinics, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba 80440-220, PR, Brazil
Author contributions: Kotze PG, Hino AAF and Queiroz NSF designed the study; Motta MP, Martins CA, Kotze PG, Queiroz NSF and Hino AAF participated in the acquisition, analysis and interpretation of the data and wrote the manuscript; Teixeira FV, Motta MP, Chebli LA, Martins CA, Quaresma AB, Silva AAP, Damião AOMC were involved in Grupo de Estudos da Doença Inflamatória Intestinal do Brasil COVID task force and critically reviewed the article for important intellectual content.
Institutional review board statement: The study was approved by the GEDIIB ethical review board under the protocol No. 002/2020 on October 28th, 2020. Informed consent was waived because the survey recruitment was self-selective. In addition, data were de-identified. Individual participant data were not published, which maintained confidentiality in all steps of study analysis. This study was conducted in compliance with regulations stated in the 1975 Declaration of Helsinki.
Informed consent statement: As this is a cross-sectional survey analyzing anonymous data, and information used derived from an unidentified database, informed consent from each individual was waived.
Conflict-of-interest statement: Kotze PG reports grants and personal fees from Takeda, grants and personal fees from Pfizer, personal fees from Janssen, personal fees from Abbvie, personal fees from Novartis, personal fees from Ferring, outside the submitted work.
Data sharing statement: Study data are de-identified. Data are provided only for the approved study. Data will not be shared with anyone outside of the named members of the investigator team.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Paulo Gustavo Kotze, MD, MSc, PhD, Doctor, Professor, Surgeon, IBD Outpatient Clinics, Pontificia Universidade Católica do Paraná (PUCPR), Rua Bruno Filgueira, 369 cj.1205, Curitiba 80440-220, PR, Brazil. pgkotze@hotmail.com
Received: December 17, 2020
Peer-review started: December 17, 2020
First decision: January 23, 2021
Revised: January 28, 2021
Accepted: February 25, 2021
Article in press: February 25, 2021
Published online: March 28, 2021
ARTICLE HIGHLIGHTS
Research background

The coronavirus disease 2019 (COVID-19) pandemic is a public health emergency of international concern, and Brazil is currently one of the most affected countries.

Research motivation

It is uncertain whether patients with inflammatory bowel disease (IBD) are at a greater risk for developing COVID-19 or its complications. There are scarce data in large countries correlating IBD patients, the risk of COVID-19 complications and mortality.

Research objectives

This study aimed to evaluate geographical distribution of IBD patients at highest risk and correlate these data with COVID-19 mortality rates in different states of Brazil.

Research methods

It was a web-based survey adapted from the British Society of Gastroenterology guidelines. We included demographic data and risk factors for complications from COVID-19. Patients were categorized as highest, moderate or lowest individual risk.

Research results

The proportion of IBD patients at highest risk for COVID-19 complications depends on individual aspects and can vary in specific regions. No correlation between patients with IBD at highest risk and COVID-related mortality rates was demonstrated in different regions of the country.

Research conclusions

This is one of the largest studies analyzing the risk of patients with IBD during COVID-19 pandemic globally.

Research perspectives

These data can be important to large countries such as Brazil, United States, Russia and India, which are currently facing significant problems in terms of controlling the pandemic. Even European countries, facing a second wave of COVID-19 infection, can base future research or decisions using these data as an example.