评估新冠肺炎大流行对儿科炎症性肠病入院和新诊断严重程度的影响。

IF 1.8 Q3 GASTROENTEROLOGY & HEPATOLOGY
Crohn's & Colitis 360 Pub Date : 2023-10-25 eCollection Date: 2023-10-01 DOI:10.1093/crocol/otad062
Malika Waschmann, Ariana Stuart, Kimberly Trieschmann, Henry C Lin, Anna K Hunter
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引用次数: 0

摘要

简介:新冠肺炎大流行给儿科炎症性肠病(IBD)的诊断和管理带来了新的挑战。许多患者通过远程医疗只能有限地接触到他们的提供者,许多人选择推迟非紧急治疗。方法:对2018年1月至2021年8月Doernbecher儿童医院儿科胃肠科就诊的IBD患者进行回顾性图表回顾。研究队列分为2组:新冠肺炎大流行开始前(2018年1月1日至2020年2月28日)和大流行期间(2020年3月1日到2021年8月1日)。收集的变量包括:年龄、性别、种族、民族、IBD类型、保险类型、居住地。选择的主要结果指标集中在疾病严重程度、初始治疗类型或提供的手术干预。对新诊断的患者进行亚组分析。使用独立t检验、卡方分析和Wilcoxon秩和检验对数据进行分析。结果:211名患者符合纳入标准,107名(72例新诊断,35例入院)在新冠肺炎前,104名(67例新诊断、37例入院)为新冠肺炎期间。新冠肺炎时期的患者粪便钙卫蛋白水平较高,更有可能开始进行生物治疗。新冠肺炎期间因IBD发作入院的患者更有可能需要手术干预。对新诊断患者的亚组分析显示,合并抑郁和焦虑的发生率较高。结论:我们的综述发现,新诊断的儿童IBD患者以及因新冠肺炎发作入院的儿童患者的疾病严重程度增加。新冠肺炎期间焦虑和抑郁率的增加可能导致疾病严重程度恶化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing the Impact of the COVID-19 Pandemic on the Severity of Pediatric Inflammatory Bowel Disease Admissions and New Diagnoses.

Introduction: The COVID-19 pandemic has introduced new challenges to the diagnosis and management of pediatric inflammatory bowel disease (IBD). Many patients have had only limited access to their providers through telemedicine, and many chose to delay nonemergent treatment.

Methods: A retrospective chart review of patients with IBD seen by the Pediatric Gastroenterology Division at Doernbecher Children's Hospital from January 2018 to August 2021 was conducted. The study cohort was divided into 2 groups: those presenting before the onset of the COVID-19 pandemic (January 1, 2018 to February 28, 2020) and those presenting during the pandemic (March 1, 2020 to August 1, 2021). Variables collected included: age, sex, race, ethnicity, IBD type, insurance type, location of residence. Primary outcome measures selected focused on disease severity, initial type of treatment, or surgical intervention offered. A subgroup analysis of the new diagnosis patients was performed. Data were analyzed using independent t-tests, chi-squared analysis, and Wilcoxon rank sum tests.

Results: Two hundred and eleven patients met inclusion criteria, 107 (72 new diagnoses, 35 admissions) within the pre-COVID epoch and 104 (67 new diagnoses, 37 admissions) within the during-COVID epoch. Patients in the during-COVID epoch had higher fecal calprotectin level and were more likely to be started on a biologic as initial treatment. Patients admitted during COVID for IBD flare were more likely to require surgical intervention. Subgroup analysis of newly diagnosed patients revealed higher incidence of comorbid depression and anxiety.

Conclusions: Our review identified increased disease severity in newly diagnosed pediatric patients with IBD as well as pediatric patients admitted for flare during COVID. Increases in anxiety and depression rates during COVID may have contributed to worsened disease severity.

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来源期刊
Crohn's & Colitis 360
Crohn's & Colitis 360 Medicine-Gastroenterology
CiteScore
2.50
自引率
0.00%
发文量
41
审稿时长
12 weeks
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