Questionnaire-Based Study of 81 Patients in Poland to Evaluate the Course of Inflammatory Bowel Disease and the Effects of the COVID-19 Pandemic on Quality of Life and Mental State from February to June 2021

Abstract

Background The COVID-19 pandemic affected many people worldwide, including those with chronic diseases. Our objective was to analyze its influence on medical care and the course of inflammatory bowel disease (IBD) in Poland. Material/Methods In 2021, 81 patients in Poland with IBD completed an original anonymous questionnaire about the impact of the COVID-19 pandemic on the course of their disease and mental status. The printed questionnaire was distributed to IBD patients treated at the Gastroenterology Outpatient Clinic of the University Clinical Hospital in Białystok, and an online questionnaire was sent to patients via social media. Statistical analysis was performed using the chi-squared test, with a significance level of P< 0.05. Results The study group consisted of 46 women and 35 men with a mean age of 32.42 years. Fifty-nine patients had ulcerative colitis and 22 had Crohn disease. Patients reported significant deterioration in medication availability (50.62%) and restricted access to gastroenterology outpatient clinics (51.90%) ( P <0.05). Of patients who contracted COVID-19, 89.47% did not require hospitalization, 32.10% (26/81) were asymptomatic, mild, or moderate, despite immunosuppressive biological treatment (27.16%, 22/81), or steroids (18.52%, 15/81). Over 50% of respondents stated the pandemic negatively affected their mental state and 30% of them associated that with worsening IBD. Conclusions During the pandemic, respondents were mainly concerned with difficulties in accessing the gastroenterology clinic and limited drug availability. The pandemic negatively affected patients’ mental state. In cases of COVID-19 disease, patients with IBD were mostly asymptomatic and did not require hospitalization, despite therapy affecting the immune system.

Influence of the COVID-19 Outbreak on Health-Related Quality of Life in Inflammatory Bowel Disease Patients in China: A Cross-Sectional Questionnaire-Based Study

“…Speci cally, IBD patients using steroids and 5-ASA are considered to be at a higher risk of contracting COVID-19 [25]. Conversely, biological agents (anti-TNF-α) are considered a protective factor against severe COVID-19, possibly due to the overexpression of TNF-α in COVID-19 [24]. Among the 224 IBD patients in our survey, 172 were found to have contracted COVID-19, representing 77% of the participants.…”

“…In our study, the majority of IBD patients (129) were being treated with mesalazine (5-ASA). There are reports in the literature suggesting that medications used to treat IBD can in uence the immune system, modulate immunity, and potentially increase the susceptibility of IBD patients to COVID-19 infection [24]. Speci cally, IBD patients using steroids and 5-ASA are considered to be at a higher risk of contracting COVID-19 [25].…”

“…The pandemic may also lead to shortages of these medications [20,21,24]. Consequently, some IBD patients may struggle to adhere to their prescribed medication regimens, particularly for IBD patients who during periods of remission and relapse, if they discontinue taking medicine in such cases could exacerbate their condition and reduce their HRQoL [21,24]. Our recommendation is that all IBD patients should continue taking their prescribed medications for IBD as directed by their healthcare providers during the COVID-19 pandemic and strive to avoid discontinuing their IBD medications.…”

“…Firstly, medications used to treat IBD, such as steroids and 5-ASA, may heighten the risk of COVID-19 infection among IBD patients [25]. On the other hand, some biological agents may offer protection [24]. However, the mechanisms of these medications are not yet fully understood, necessitating further research to comprehensively assess the risk of COVID-19 infection in IBD patients and the e cacy and risks associated with immunomodulators.…”

Editorial: Challenges in inflammatory bowel disease: current, future and unmet needs, volume II

“…Unemployment and other chronic comorbidities weighed negatively on HRQoL. Online questionnaires during the COVID-19 pandemic mainly considered different research-related outcomes in patients with IBD (e.g., therapeutic adherence, COVID-19 vaccine-related adverse events, psychological distress, and similar) (2)(3)(4)(5)(6).…”