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Inflammatory Bowel Disease Incidence following COVID-19: A Systematic Review and Meta-Analysis
Aris P Agouridis1,2, Alexandros Hadjivasilis3, Georgios Vougiouklakis1
1Department of Internal Medicine, German Medical Institute, Limassol, Cyprus.
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 2 = 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 2 = 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 2 = 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.
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