Inflammatory Bowel Disease in the COVID-19 Pandemic: the Patients' Perspective

Abstract

Background: The coronavirus disease 2019 [COVID-19] pandemic is affecting lives worldwide. The influence of inflammatory bowel disease [IBD] medication and IBD itself on COVID-19 is controversial. Additionally, IBD-focused guidance is scarce.

Objective: Our aims were to determine COVID-19 prevalence/exposure, perception and information sources, medication compliance, patient behaviour and physician contact among patients with IBD compared with non-IBD controls.

Methods: A cross-sectional anonymous survey of patients with IBD [N = 415] at one university IBD clinic and one gastroenterology practice, matched 4:1 with control participants [N = 116], was performed.

Results: Patients with IBD had a high fear of infection. This was more pronounced in patients taking immunosuppressants and it extended to hospitals, private practices and public places, such as supermarkets. IBD patients reported leaving their homes less frequently than their peers without IBD. A total of 90% of patients with IBD reported washing their hands more frequently. Patients taking immunosuppressants were concerned about interactions between medication and COVID-19, whereas patients taking 5-aminosalicylates were not. Nonetheless, 96.4% of patients adhered to continuing their medication. Patients sought guidance primarily from television and internet news sites. Video consultations were found to be a suitable solution for a subset of patients who are young, have a high level of fear and leave their home less frequently than their peers, whereas overall acceptance of video consultations was limited.

Conclusion: Patients with IBD are significantly more affected by the COVID-19 pandemic than their non-IBD peers, but they continue to adhere to their medication regimens. IBD-focused COVID-19 information should be actively conveyed.

Keywords: COVID-19; Inflammatory bowel disease; patient behaviour.

Figure 1.

Subgroup analysis of different IBD medications for Likert-scale questions 1, 2, 6 and 8. Q6 = I would prefer a video consultation over a face-to-face consultation. For questions 1, 2 and 8 all subgroups were compared to the control group. The top five bars represent subgroups of patients from the IBD group taking different medications, and the bottom two bars represent all controls and all patients with IBD [Q1, Q2, Q8] or all patients with IBD Q6. No immunosuppression = 5-aminosalicylates or no medication [Mann–Whitney U-test, *p < 0.05].