Influence of the COVID-19 Outbreak on Disease Activity and Quality of Life in Inflammatory Bowel Disease Patients

Chiara Conti; Ilenia Rosa; Luigia Zito; Laurino Grossi; Konstantinos Efthymakis; Matteo Neri; Piero Porcelli

doi:10.3389/fpsyt.2021.664088

Influence of the COVID-19 Outbreak on Disease Activity and Quality of Life in Inflammatory Bowel Disease Patients

Front Psychiatry. 2021 Apr 22:12:664088. doi: 10.3389/fpsyt.2021.664088. eCollection 2021.

Authors

Chiara Conti¹, Ilenia Rosa², Luigia Zito¹, Laurino Grossi³, Konstantinos Efthymakis⁴, Matteo Neri⁴, Piero Porcelli¹

Affiliations

¹ Department of Psychological, Health, and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Chieti, Italy.
² Department of Dynamic and Clinical Psychology, and Health Studies, "Sapienza" University of Rome, Rome, Italy.
³ Gastroenterology Unit, Spirito Santo Hospital, Pescara, Italy.
⁴ Department of Medicine and Aging Sciences, 'G. D'Annunzio' University of Chieti-Pescara, Chieti, Italy.

Abstract

Objective: The present preliminary cross-sectional study aimed to investigate the extent to which health-related quality of life of patients with inflammatory bowel disease (IBD) was influenced by the outbreak of Covid-19 while controlling for disease activity. Methods: Two samples of 195 (recruited before Covid-19 outbreak) and 707 patients (recruited during the Covid-19-related lockdown) were included. Psychological distress (Hospital Anxiety and Depression Scale, HADS), quality of life (Inflammatory Bowel Disease Questionnaire, IBDQ), and somatization (Patient Health Questionnaire, PHQ-12) were concurrently assessed. Results: Patients with active IBD were more prevalently affected by ulcerative colitis (60.2%, η² = 0.12) and, expectedly, showed higher psychological distress (HADS, d = 0.34) and somatization (PHQ-12, d = 0.39), as well as poorer disease-specific health-related quality of life (effect sizes for the total and subscale IBDQ scores in the large range of d > 0.50). Hierarchical regression models revealed that setting (pre-Covid-19 outbreak vs. during lockdown) (p < 0.001) explained only a small portion (8%) of the IBDQ variance. IBD-related factors (ulcerative colitis and disease activity) and psychological factors (psychological distress and somatization) added a significant amount of 25 and 27%, respectively, to the explained IBDQ variance. The final model predicted 59% of the explained IBDQ variance. Conclusion: Clinical and psychological manifestations seem to be major impairments in IBD patients both before and during the Covid-19 outbreak. Furthermore, the quality of life of IBD patients seem to be more influenced by psychological and somatizing distressing symptoms than the pandemic-related living conditions.

Keywords: COVID-19; disease activity; health-related quality of life; inflammatory bowel disease; outbreak; psychological distress.