Inflammatory Bowel Disease patients requiring surgery can be treated in referral centres regardless of the COVID-19 status of the hospital: results of a multicentric European study during the first COVID-19 outbreak (COVIBD-Surg)

Rottoli, Matteo; Pellino, Gianluca; Tanzanu, Marta; Frontali, Alice; Carvello, Michele; Foppa, Caterina; Kontovounisios, Christos; Tekkis, Paris; Colombo, Francesco; Sancho‐Muriel, Jorge; Frasson, Matteo; Celentano, Valerio; Spinelli, Antonino; Sampietro, Gianluca; Poggioli, Gilberto

doi:10.1007/s13304-021-01119-y

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Similarly, Xu et al 50 and Bezzio et al 11 recorded significantly higher mortality in CD (OR 19.93) and UC (OR 22.65) patients, respectively. The evidence indicates that many other factors, such as the use of biologics 12 , advanced age 11 , 42 , 95 , active IBD status, higher Charlson comorbidity index score 11 , comorbidities, use of corticosteroids 48 , 101 , 112 and thiopurines 101 were significantly associated with COVID-19 mortality in the IBD population. Very recent evidence also indicates a non-significant effect of corticosteroids in mortality among patients with acute respiratory distress syndrome (ARDS), although positive evidence is reported in more recent randomized clinical trials 113 .…”

Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Abdulla

Mohammed

AlQamish

et al. 2022

Sci Rep

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There is conflicting evidence concerning the effect of inflammatory bowel disease (IBD) on COVID-19 incidence and outcome. Hence, we aimed to evaluate the published evidence through a systematic review process and perform a meta-analysis to assess the association between IBD and COVID-19. A compressive literature search was performed in PubMed/Medline, Scopus, Embase, and Cochrane Library from inception to July 2021. A snowball search in Google, Google Scholar, Research Gate, and MedRxiv; and bibliographic research were also performed to identify any other relevant articles. Quantitative observational studies such as cohort, cross-sectional, and case–control studies that assessed the incidence, risk, and outcomes of COVID-19 among the adult IBD patients published in the English language, were considered for this review. The incidence and risk of COVID-19, COVID-19 hospitalization, the severity of COVID-19, and mortality were considered as the outcomes of interest. The Joanna Briggs Institute critical appraisal checklist was used for quality assessment. A subgroup and sensitivity analysis were performed to explore the heterogeneity and robustness of the results, respectively. A total of 86 studies out of 2828 non-duplicate records were considered for this meta-analysis. The studies were single or multicentric internationally from settings such as IBD centres, medical colleges, hospitals, or from the general public. Most of the studies were observed to be of good quality with an acceptable risk of bias. The pooled prevalence of COVID-19, COVID-19 hospitalization, severe COVID-19, and mortality in the IBD population were 6.10%, 10.63%, 40.43%, and 1.94%, respectively. IBD was not significantly (p > 0.05) associated with the risk of COVID-19, COVID-19 hospitalization, severe COVID-19, and mortality. In contrast, ulcerative colitis was significantly associated with a higher risk of COVID-19 (OR 1.37; p = 0.01), COVID-19 hospitalization (OR 1.28; p < 0.00001), and severe COVID-19 (OR 2.45; p < 0.0007). Crohn’s disease was significantly associated with a lesser risk of severe COVID-19 (OR 0.48; p = 0.02). Type of IBD was a potential factor that might have contributed to the higher level of heterogeneity. There was a significant association between ulcerative colitis and increased risk of COVID-19, COVID-19 hospitalization, and severe COVID-19 infection. This association was not observed in patients with Crohns' disease or in those diagnosed non-specifically as IBD.

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Section: Discussionmentioning

confidence: 99%

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Abdulla

Mohammed

AlQamish

et al. 2022

Sci Rep

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“…The SARS-CoV-2 pandemic deeply affected surgical practice globally, with a reduction of emergency admissions and surgical procedures-for several reasons, including staff shortages, healthcare workers fear of infections [3,7,[14][15][16][17][18]-eventually impacting patients suffering from colorectal cancer. [2,19,20] Evidence supports the feasibility and safety of surgery for common colorectal conditions that, even if non-emergent, might impair patient's quality of life and long-term survival if treatment is delayed [21][22][23]. However, it is important that strategies are developed to mitigate the risk of complications related to perioperative SARS-CoV-2 infection [11,15,[20][21][22][24][25][26][27][28][29]-which is reported to have a detrimental effect on short-term outcomes of surgery [30].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and usability of a regional hub model for colorectal cancer services during the COVID-19 pandemic

et al. 2022

Self Cite

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The outbreak of the COVID-19 pandemic produced unprecedented challenges, at a global level, in the provision of cancer care. With the ongoing need in the delivery of life-saving cancer treatment, the surgical management of patients with colorectal cancer required prompt significant transformation. The aim of this retrospective study is to report the outcome of a bespoke regional Cancer Hub model in the delivery of elective and essential colorectal cancer surgery, at the height of the first wave of the COVID-19 pandemic. 168 patients underwent colorectal cancer surgery from April 1st to June 30th of 2020. Approximately 75% of patients operated upon underwent colonic resection, of which 47% were left-sided, 34% right-sided and 12% beyond total mesorectal excision surgeries. Around 79% of all resectional surgeries were performed via laparotomy, and the remainder 21%, robotically or laparoscopically. Thirty-day complication rate, for Clavien–Dindo IIIA and above, was 4.2%, and 30-day mortality rate was 0.6%. Re-admission rate, within 30 days post-discharge, was 1.8%, however, no patient developed COVID-19 specific complications post-operatively and up to 28 days post-discharge. The established Cancer Hub offered elective surgical care for patients with colorectal cancer in a centralised, timely and efficient manner, with acceptable post-operative outcomes and no increased risk of contracting COVID-19 during their inpatient stay. We offer a practical model of care that can be used when elective surgery “hubs” for streamlined delivery of elective care needs to be established in an expeditious fashion, either due to the COVID-19 pandemic or any other future pandemics.

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“…Visto que seu uso no momento da cirurgia é um dos fatores de risco para complicação moderada a graves. (Rottoli, 2021).…”

Section: Principais Complicaçõesunclassified

Aspectos do tratamento cirúrgico nas doenças inflamatórias intestinais complicadas

Roman,

Góes,

Roman

et al. 2024

Braz. J. Hea. Rev.

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As doenças inflamatórias intestinais envolvem a Colite Ulcerativa (RCU) e a Doença de Crohn (DC), que manifestam sintomas heterogêneos, com períodos de recaídas e remissões e impactos na qualidade de vida, saúde mental, na produtividade do trabalho do paciente. O tratamento consiste em farmacoterapia, mas 20% a 30% dos pacientes necessitam de cirurgia durante o curso da doença. Este trabalho visa elencar as indicações cirúrgicas da doença inflamatória intestinal, destacando o impacto da cirurgia na qualidade de vida e eventuais complicações. Trata-se de uma revisão narrativa de literatura, realizada a partir de pesquisa no PUBMED com os descritores “Inflammatory Bowel Diseases”; “General Surgery”; “Ulcerative Colitis entre 2018 e 2024. Foram encontrados 386 artigos, após análise de títulos e resumos foram efetivamente selecionados 22 artigos por compreenderem o tema proposto, logo não necessitou de apreciação do Comitê de Ética e Pesquisa. A cirurgia é recomendada aos que não respondem a terapia de resgate com corticoides, infliximabe ou ciclosporina e naqueles com complicações, como: megacólon tóxico, hemorragia grave, perfuração, estenose e abscessos. Existem diversas opções cirúrgicas, como a proctocolectomia com bolsa ileoanal (IPAA), colectomia total com ileostomia terminal ou com anastomose ileorretal, havendo melhoria na qualidade de vida, no crescimento e a nutrição dos pacientes pediátricos após a IPAA. Portanto, conclui-se que é necessário grande enfoque da equipe multidisciplinar no esclarecimento ao paciente para tomada de decisões, implementação de plano de cuidados e seguimento terapêutico, para evitar recidivas e complicações que reduzem a qualidade de vida.

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Inflammatory Bowel Disease patients requiring surgery can be treated in referral centres regardless of the COVID-19 status of the hospital: results of a multicentric European study during the first COVID-19 outbreak (COVIBD-Surg)

Cited by 7 publications

References 20 publications

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis

Feasibility and usability of a regional hub model for colorectal cancer services during the COVID-19 pandemic

Aspectos do tratamento cirúrgico nas doenças inflamatórias intestinais complicadas

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