Background: The management of inflammatory bowel disease (IBD) requires frequent endoscopic assessment. It is unknown if measures put in place to reduce the spread of the virus SARS-CoV-2, including the delay of non-urgent patient assessments, resulted in deleterious outcomes for patients with IBD. Therefore, we aimed to determine if delays in endoscopy during the COVID-19 pandemic were associated with an increased risk of adverse IBD outcomes (emergency room, ER presentation, hospitalization, surgery, or escalation of drug therapy).
Methods: A retrospective cohort study was performed in patients with IBD scheduled for outpatient endoscopies between March and August 2019 and 2020 at two tertiary care centers affiliated with Western University, London, Canada. Data pertaining to endoscopy timing, IBD drug prescription, ER attendance, hospitalization, and surgery were collected.
Results: A total of 1160 endoscopies (2019, n = 718; 2020, n = 442) occurred during the study periods in 669 (2019) and 414 (2020) patients with IBD, respectively. More endoscopies were delayed in 2020 than 2019 (26.7% vs. 9.7%, respectively, P < 0.0001). Endoscopy delay was not associated with an increased risk of an adverse IBD outcome (OR = 1.23, 95%CI = 0.89-1.34, P = 0.20). Fewer adverse IBD outcomes were seen in the 2020 cohort who had endoscopy delays (n = 33/115, 28.7%) versus those without delay (n = 176/299, 58.9%, P < 0.0001).
Conclusion: More endoscopy delays occurred during the COVID-19 pandemic; however, delays in general were not associated with adverse IBD outcomes, and in particular, endoscopy delays during the COVID-19 pandemic were associated with fewer deleterious IBD outcomes, suggesting that patients with IBD in need of urgent endoscopy were appropriately identified.
Keywords: COVID-19 pandemic; ER access; Endoscopy delays; Hospitalization; Inflammatory bowel disease; Surgery.
© The Author(s) 2022. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.