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GE Port J Gastroenterol . Inflammatory Bowel Disease Incidence following COVID-19: A Systematic Review and Meta-Analysis

tetano

Editor, Senior Moderator
GE Port J Gastroenterol


. 2026 Feb 11;33(1):387-395.
doi: 10.1159/000550703. eCollection 2026 Jan-Dec.
Inflammatory Bowel Disease Incidence following COVID-19: A Systematic Review and Meta-Analysis

Aris P Agouridis[SUP] 1 2 [/SUP], Alexandros Hadjivasilis[SUP] 3 [/SUP], Georgios Vougiouklakis[SUP] 1 [/SUP], Theognosia Ioannou[SUP] 3 [/SUP], Stavria Charitonos[SUP] 3 [/SUP], Marios Christoforou[SUP] 3 [/SUP], Evangelos Ionas[SUP] 3 [/SUP], Dimitrios Giannakakis[SUP] 3 [/SUP], Nikolaos Spernovasilis[SUP] 4 [/SUP]


Affiliations
Abstract

in English, Portuguese
Background: A surge of cases of autoimmune and inflammatory diseases, such as inflammatory bowel disease (IBD), have been reported after coronavirus disease 2019 (COVID-19).
Objective: The objective of this study was to assess whether COVID-19 has a role in IBD risk.
Methods: We searched MEDLINE (PubMed), Cochrane Library and OpenGrey databases up to October 30, 2025, for studies evaluating the incidence of IBD following COVID-19 infection (PROSPERO ID: CRD42024534916).
Results: After a full-text review of 84 manuscripts, a total of 8 studies were used in the qualitative analysis. The studies were conducted between 2023 and 2024 and included in total 28,659,801 people, 8,560,826 of which were previously infected with COVID-19 and 20,098,975 that served as healthy controls. The results from the pooled synthesis of 6 studies indicate a 39% higher incidence of IBD in people that were previously infected with COVID-19 (risk ratio [RR] 1.39, 95% CI: [1.12-1.74], p = 0.003, I [SUP]2[/SUP] = 97%). Furthermore, from the pooled analysis of 4 eligible studies, a higher incidence of new ulcerative colitis cases following COVID-19 was observed (RR 1.25, 95% CI: [1.17-1.33], p < 0.00001, I [SUP]2[/SUP] = 0%). On the contrary, no difference was observed in Crohn's disease incidence between COVID-19 and non-COVID-19 patients (RR 1.23 95% CI: [0.88, 1.72], p = 0.22, I [SUP]2[/SUP] = 91%).
Conclusions: The findings of the present meta-analysis suggest an increased risk of IBD after COVID-19 infection. Although this is more evident regarding ulcerative colitis, we believe that the available outcomes arising from future studies will clarify the real incidence of Crohn's disease following COVID-19 infection.

Keywords: COVID-19; Crohn’s disease; Inflammatory bowel disease; SARS-CoV-2; Ulcerative colitis.

 
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