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COVID-19; Immunosuppression; Inflammatory bowel disease COVID-19; Immunosupressió; Malaltia inflamatòria intestinal COVID-19; Inmunosupresión; Enfermedad inflamatoria intestinal (1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case−control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March−July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3−5.9), occupational risk (OR: 2.9; 95%CI: 1.8−4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2−2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09−0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution.

Resumen Objetivos Analizar las caracteristicas al ingreso, el curso evolutivo y el pronostico de la hemorragia digestiva alta (HDA) en el paciente anciano. Material y metodos Estudio prospectivo en el que se incluyeron 103 pacientes con edad igual o superior a 80 anos, que ingresaron en una Unidad de Sangrantes por un episodio de HDA en un ano. Analizamos los antecedentes personales, caracteristicas de la hemorragia, realizacion de la endoscopia urgente diagnostica y terapeutica y factores pronosticos asociados. Resultados La etiologia mas frecuente de la HDA fue el sangrado por ulcera gastroduodenal en el 65,1%, siendo el 60,2% consumidores cronicos de antiinflamatorios no esteroideos. Se realizo endoscopia diagnostica urgente en todos ellos, con una eficacia del 94,2% y terapeutica en el 28,2%. La tasa de resangrado fue del 8%, requiriendo cirugia urgente el 4,9%, con una mortalidad global del 5,8%. Conclusiones La realizacion de endoscopia urgente y la aplicacion de terapeutica endoscopica es un metodo seguro y eficaz para detener el sangrado por HDA en el anciano, lo cual ha reducido la necesidad de cirugia urgente, mejorando la supervivencia del enfermo anciano sangrante.

In the course of inflammatory bowel disease (IBD) a number of extraintestinal manifestations are known to occur, being the dermatological ones often associated to both ulcerative colitis and Crohn's disease. Pyoderma gangrenosum and erythema nodosum are the most frequent, but there are other skin manifestations less frequently reported such as leukocytoclastic vasculitis. We present a case, in which Crohn's disease and leukocytoclastic vasculitis were simultaneously diagnosed, and corticoids treatment achieved complete remission of the both cutaneous and gastrointestinal manifestations.

To evaluate the patient characteristics, outcome, and prognosis of upper gastrointestinal haemorrhage in the elderly.A prospective study was conducted on 103 patients aged 80 years and over, admitted to a Gastrointestinal Bleeding Unit after an episode of upper gastrointestinal bleeding. We analysed the personal history, the characteristics of the bleeding event, and whether an urgent diagnostic or therapeutic endoscopy was performed, in order to identify clinical data and endoscopic findings that may have an influence on the outcome of the haemorrhage.The major cause of the haemorrhage was peptic ulcer in 65.1%, and 60.2% of patients were on chronic treatment with non-steroidal anti-inflammatory drugs. An urgent diagnostic endoscopy was performed in all of them, identifying the source of bleeding in 94.2%, and treatment was carried out on 28.2%. The likelihood of rebleeding was 8%, and 4.9% of patients underwent emergency surgery, with an overall mortality rate of 5.8%.The performance of urgent endoscopy and the application of endoscopic haemostasis are safe and effective in stopping upper gastrointestinal bleeding in the elderly. This has significantly reduced the need for emergency surgery, improving the survival of the bleeding elderly patient and preventing recurrent bleeding.

In the course of inflammatory bowel disease (IBD) a number of extraintestinal manifestations are known to occur, being the dermatological ones often associated to both ulcerative colitis and Crohn's disease. Pyoderma gangrenosum and erythema nodosum are the most frequent, but there are other skin manifestations less frequently reported such as leukocytoclastic vasculitis. We present a case, in which Crohn's disease and leukocytoclastic vasculitis were simultaneously diagnosed, and corticoids treatment achieved complete remission of the both cutaneous and gastrointestinal manifestations.