Management of patients with inflammatory bowel disease and outcomes during the first wave of the Covid-19 pandemic

Viola, Anna; Giambò, Federica; Chiappetta, Michele Francesco; Costantino, Giuseppe; Pallio, Socrate; Fries, Walter

doi:10.1016/j.dld.2021.03.021

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…Most current studies focus on the diagnosis and management of IBD patients infected with COVID-19. A few researches showed that patients on intravenous biological treatments were more likely to stop or delay treatment ( 15 , 16 ). In a recent report, ~27.7% of patients with IBD discontinued their medication during the COVID-19 epidemic, among patients of whom, 29.3% suffered aggravated conditions ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

Delayed Infliximab Treatment Affects the Outcomes of Patients With Crohn's Disease During the COVID-19 Epidemic in China: A Propensity Score-Matched Analysis

Chen

et al. 2022

Front. Med.

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Background: The coronavirus disease 2019 (COVID-19) has swept the world and led to delays in the treatment of Crohn's disease patients treated with biologics. This study aims to investigate the risk factors for delayed treatment during the epidemic and to observe the short- and long-term influences of such delays among them to provide some reference on treatments.Methods: This study retrospectively enrolled patients diagnosed with Crohn's disease who received infliximab treatment between January 23, 2020 and April 30, 2020. Univariate and multivariate logistic regression were used to analyze the risk factors for delayed treatment. Propensity score matching was utilized to compare the effects of delayed treatment on the short- and long-term outcomes.Result: Our cohort identified a total of 53 patients with a delay rate of 71.7%. Of these patients, 38 were in the delayed group, and 15 were in the non-delayed group. Logistic regression analysis showed that the baseline levels of C-reactive protein were an influence factor for delaying treatment (OR = 0.967, 95% CI = 0.935–1.000, p = 0.047). Regarding short-term effects, the delayed group had a lower decrease in the Crohn's Disease Activity Index than the non-delayed group [−43.3 (−92.7, −9.7) vs. −17.3 (−29.0, 79.9), p = 0.038] and significantly higher long-term readmission rates (33.3% vs. 0%, p = 0.014).Conclusion: Delayed infliximab treatment could affect the short- and long-term outcomes in patients with Crohn's disease. Our study suggested that the regulated course of treatment with biological agents should be performed effectively and that education should be enhanced to minimize delays in treatment.

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Section: Introductionmentioning

confidence: 99%

Delayed Infliximab Treatment Affects the Outcomes of Patients With Crohn's Disease During the COVID-19 Epidemic in China: A Propensity Score-Matched Analysis

Chen

et al. 2022

Front. Med.

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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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A Patient-Prioritized Agenda for Information Needs During the COVID-19 Pandemic: A Qualitative Study of Patients With Inflammatory Bowel Disease

Long

Grewe²,

Cerciello

et al. 2021

Crohn's &Amp; Colitis 360

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Background/Aims Patients with inflammatory bowel disease (IBD) may be at risk for complications due to the COVID-19 pandemic. We performed a qualitative study to better understand IBD patient experiences and concerns when navigating the COVID-19 pandemic, with the goal of prioritizing patients’ information needs. Methods We conducted a series of semi-structured virtual focus groups at 6 months, then member-checking focus groups 1 year into the COVID-19 pandemic. We included questions on patients’ experiences navigating the pandemic with IBD, differences in their experience as compared to peers, their concerns and fears, as well as preferred information sources. Transcribed focus groups were coded and content-analyzed to summarize key areas of interest and identify themes. We focused on four areas in our content analysis process: fears, challenges, information preferences and research questions. Results A total of 26 IBD patient participants were included in the initial focus groups. Findings highlighted the many challenges faced by patients during the COVID-19 pandemic, ranging from access (bathrooms, medications, healthcare) to significant fears and concerns surrounding medications used for IBD worsening risks of COVID-19. Research questions of importance to patients centered on understanding risks for COVID-19 complications, particularly pertaining to medication utilization, with a shift over time towards understanding COVID-19 vaccination. In our member checking focus groups (n=8 participants), themes were reiterated, with a central focus of research questions pertaining to COVID-19 vaccination. Conclusions Information needs for patients during the COVID-19 pandemic centered upon understanding disease specific risks. Identified challenges and fears will inform future research agendas and communication with patients.

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Management of patients with inflammatory bowel disease and outcomes during the first wave of the Covid-19 pandemic

Cited by 4 publications

References 7 publications

Delayed Infliximab Treatment Affects the Outcomes of Patients With Crohn's Disease During the COVID-19 Epidemic in China: A Propensity Score-Matched Analysis

Delayed Infliximab Treatment Affects the Outcomes of Patients With Crohn's Disease During the COVID-19 Epidemic in China: A Propensity Score-Matched Analysis

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

A Patient-Prioritized Agenda for Information Needs During the COVID-19 Pandemic: A Qualitative Study of Patients With Inflammatory Bowel Disease

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