Increased Hospitalization for IBD Patients Seen in the ER During the COVID-19 Pandemic

Gurpreet Malhi; Gurjot Minhas; Jason Chambers; Maria Mikail; Reena Khanna; Aze Wilson

doi:10.1093/jcag/gwac020

Increased Hospitalization for IBD Patients Seen in the ER During the COVID-19 Pandemic

J Can Assoc Gastroenterol. 2022 Jun 25;5(6):271-275. doi: 10.1093/jcag/gwac020. eCollection 2022 Dec.

Authors

Gurpreet Malhi¹, Gurjot Minhas¹, Jason Chambers², Maria Mikail¹, Reena Khanna³, Aze Wilson^{3

4

5}

Affiliations

¹ Department of Medicine, Western University, London, Ontario, Canada.
² Schulich School of Medicine, Western University, London, Ontario, Canada.
³ Division of Gastroenterology, Department of Medicine, Western University, London, Ontario, Canada.
⁴ Division of Clinical Pharmacology, Department of Medicine, Western University, London, Ontario, Canada.
⁵ Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.

Abstract

Background: During the COVID-19 pandemic, the focus of many health care systems shifted in order to prioritize and allocate resources toward treating those affected by COVID-19. What this has meant for other patient populations remains unclear. We aimed to determine if there have been changes to acute care access for patients with inflammatory bowel disease (IBD) during the COVID-19 pandemic.

Methods: A retrospective cohort study was performed in IBD patients seen during (March 1, 2020 to August 31, 2020) and before (March 1, 2019 to August 31, 2019) the COVID-19 pandemic. IBD-related emergency room (ER) access, hospitalization, inpatient care and follow-up and post-discharge ER access were assessed.

Results: A total of 1229 participants were included. A higher proportion of patients accessed ER during the pandemic (44.6% versus 37.2%, P = 0.0097). A higher proportion of hospitalizations resulted from IBD-related ER visits during the pandemic period (41.6% versus 32.4%, OR = 1.48, 95% CI = 1.14 to 1.94, P = 0.0047), though length of stay was shorter (7.13 ± 8.95 days versus 10.11 ± 17.19 days, P = 0.015) and use of rescue infliximab was less. No change was seen in inpatient surgical intervention. Despite similar proportions of follow-up appointments post-hospital discharge (pre-pandemic, 77.9% versus pandemic, 78.3%), more ER visits occurred in the first 30 days following hospitalization for patients in the pandemic cohort (24.4% versus 11.1%, P = 0.0015).

Conclusion: These data highlight the need for ER services and hospitalization amongst IBD patients during the COVID-19 pandemic. This suggests that a return to pre-pandemic IBD care infrastructure is needed to mitigate the need for acute care access.

Keywords: Acute care access; COVID-19; IBD.