Impact of COVID-19 on Venous Thromboembolism in Inflammatory Bowel Disease Hospitalizations: A Propensity-Matched Analysis

Abstract

Background and Aim

Patients diagnosed with Inflammatory bowel disease (IBD) face a notably higher risk of venous thromboembolism (VTE), leading to significant health challenges. Similarly, coronavirus disease 2019 (COVID-19) is associated with an increased susceptibility to thrombosis. We aimed to assess the impact of COVID-19 on the risk of developing VTE in patients with an underlying diagnosis of IBD.

Methods

We retrospectively analyzed the National Inpatient Sample (NIS) 2020–21 to identify adult patients with IBD admitted with or without a principal diagnosis of COVID-19. We divided these patients into three groups (without COVID-19, with uncomplicated COVID-19, and with complicated COVID-19). Hospitalization characteristics, in-hospital mortality, odds of VTE, healthcare burden, and complications were compared.

Results

IBD patients with complicated COVID-19 infection had significantly higher odds of VTE (OR 5.60, 95% C.I. 3.63–8.65, p 0.001), an increase in odds of mortality (OR 29.13, 95% C.I. 22.59–37.57, p 0.001), higher healthcare resource utilization (including length of stay and total hospitalization charges), and worse secondary outcomes (like acute kidney injury and pancytopenia), compared to IBD patients without COVID-19. IBD patients with uncomplicated COVID-19 also had higher odds of VTE (OR 1.81, 95% C.I. 1.39–2.36, p 0.001) than those without COVID-19; however, there was no difference in mortality or length of stay between these two groups, and those with uncomplicated COVID-19 had lower average total hospitalization charges.

Conclusion

Patients with both complicated and uncomplicated COVID-19 were associated with higher odds of VTE compared to those without COVID-19. Patients with complicated COVID-19, in addition, also had higher odds of mortality.