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Rotondo-Trivette S, He XY, Samaan JS, Lv F, Truong E, Juels M, Nguyen A, Gao X, Zu J, Yeo YH, Ji FP, Melmed GY. Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic. World J Gastroenterol 2024; 30:2677-2688. [PMID: 38855149 PMCID: PMC11154683 DOI: 10.3748/wjg.v30.i20.2677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/10/2024] [Accepted: 02/22/2024] [Indexed: 05/27/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare in the United States. AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease (IBD) decedents. METHODS We performed a register-based study using data from the National Vital Statistics System, which reports death data from over 99% of the United States population, from January 1, 2006 through December 31, 2021. IBD-related deaths among adults 25 years and older were stratified by age, sex, race/ethnicity, place of death, and primary cause of death. Predicted and actual age-standardized mortality rates (ASMRs) per 100000 persons were compared. RESULTS 49782 IBD-related deaths occurred during the study period. Non-COVID-19-related deaths increased by 13.14% in 2020 and 18.12% in 2021 [2020 ASMR: 1.55 actual vs 1.37 predicted, 95% confidence interval (CI): 1.26-1.49; 2021 ASMR: 1.63 actual vs 1.38 predicted, 95%CI: 1.26-1.49]. In 2020, non-COVID-19-related mortality increased by 17.65% in ulcerative colitis (UC) patients between the ages of 25 and 65 and 36.36% in non-Hispanic black (NHB) Crohn's disease (CD) patients. During the pandemic, deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased. CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic. Excess death was associated with younger age among UC patients, and with NHB race among CD patients. Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.
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Affiliation(s)
- Sarah Rotondo-Trivette
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Xin-Yuan He
- Department of Infectious Disease, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Jamil S Samaan
- Karsh Division of Gastroenterology and Hepatology Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Fan Lv
- School of Mathematics and Statistics, Xi’an Jiaotong University, Xi’an 710049, Shaanxi Province, China
| | - Emily Truong
- Karsh Division of Gastroenterology and Hepatology Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Michaela Juels
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Anthony Nguyen
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States
| | - Xu Gao
- Department of Infectious Disease, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
- Division of Gastroenterology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
| | - Jian Zu
- School of Mathematics and Statistics, Xi’an Jiaotong University, Xi’an 710049, Shaanxi Province, China
| | - Yee Hui Yeo
- Karsh Division of Gastroenterology and Hepatology Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
| | - Fan-Pu Ji
- Department of Infectious Disease, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
- National and Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, Shaanxi Province, China
- Key Laboratory of Surgical Critical Care and Life Support (Xi’an Jiaotong University), Ministry of Education, Xi’an 710004, Shaanxi Province, China
| | - Gil Y Melmed
- Karsh Division of Gastroenterology and HepatologyDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
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Derks MEW, van Lierop LMA, te Groen M, Kuijpers CCHJ, Nagtegaal ID, Hoentjen F. Long-Term Impact of the COVID-19 Pandemic on Inflammatory Bowel Disease Healthcare Utilization: A 2-Year Nationwide Update. Inflamm Bowel Dis 2024; 30:146-149. [PMID: 37000678 PMCID: PMC10769775 DOI: 10.1093/ibd/izad055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Indexed: 04/01/2023]
Affiliation(s)
- Monica E W Derks
- Inflammatory Bowel Disease Center, Department of Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Lisa M A van Lierop
- Inflammatory Bowel Disease Center, Department of Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Maarten te Groen
- Inflammatory Bowel Disease Center, Department of Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Iris D Nagtegaal
- Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Frank Hoentjen
- Inflammatory Bowel Disease Center, Department of Gastroenterology, Radboud University Medical Center, Nijmegen, the Netherlands
- Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, AB, Canada
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Naseem K, Sohail A, Quang Nguyen V, Khan A, Cooper G, Lashner B, Katz J, Cominelli F, Regueiro M, Mansoor E. Predictors of Hospital-related Outcomes of COVID-19 Infection in Patients With Inflammatory Bowel Disease in the Early Pandemic Phase: A Nationwide Inpatient Database Survey. Inflamm Bowel Dis 2023:izad200. [PMID: 37725039 DOI: 10.1093/ibd/izad200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) are at higher risk for severe COVID-19 infection. However, most studies are single-center, and nationwide data in the United States are lacking. This study aimed to investigate hospital-related outcomes and predictors of these outcomes in patients with IBD and COVID-19 infection. METHODS The National Inpatient Sample and National Readmission database were queried for all the patient hospitalizations with IBD with concurrent COVID-19 in the study group and non-COVID-19 related hospitalizations in the control group. For patients under 18 years, elective and trauma-related hospitalizations were excluded. Primary outcomes included mortality, septic shock, mechanical ventilation, and intensive care utilization. Secondary outcomes included length of stay and total hospitalization costs. RESULTS From this query, 8865 adult patients with IBD and COVID-19 were identified. These patients were relatively older (62.8 vs 57.7 years, P < .01), and the majority were females (52.1% with COVID-19 vs 55.2% without COVID-19). Patients with IBD and COVID-19 had higher mortality (12.24% vs 2.55%; P < .01), increased incidence of septic shock (7.9% vs 4.4%; P < .01), mechanical ventilation (11.5% vs 3.7%; P < .01), and intensive care utilization (12% vs 4.6%; P < .01). These patients also had higher mean length of stay (8.28 days vs 5.47 days; P < .01) and total hospitalization costs ($21 390 vs $16 468; P < .01) than those without COVID-19 infection. CONCLUSIONS Patients with IBD and COVID-19 have worse outcomes, with a higher incidence of severe COVID-19 disease, leading to higher mortality rates, longer lengths of stay, and increased total hospitalization costs. Encouraging preventive health measures and treating promptly with advanced COVID-19 therapies may improve outcomes and decrease the healthcare burden.
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Affiliation(s)
| | - Abdullah Sohail
- The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Ahmad Khan
- Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Jeffry Katz
- Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Emad Mansoor
- Case Western Reserve University, Cleveland, OH, USA
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Zhang E, Christensen B, Macrae FA, Leong R. The Effects of the COVID Pandemic on Patients with IBD: Lessons Learned and Future Directions. J Clin Med 2022; 11:jcm11237002. [PMID: 36498577 PMCID: PMC9740633 DOI: 10.3390/jcm11237002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic has caused extended global disruption and changed healthcare behaviour and delivery in patients with inflammatory bowel disease, many of whom take immune modifying treatment. Although there were fears about the vulnerability of IBD patients to SARS-CoV-2 infection, we have learnt that overall IBD patients are equivalent to the general population in both viral acquisition and infection outcomes. Overall IBD patients obtain effective vaccine-induced immune responses, although in some groups an additional vaccine dose is required to constitute a primary course. The pandemic has led to significant changes in healthcare delivery, some of which will be enduring. As we grapple with the challenges of recovery, the lessons learnt will continue to be important in optimising outcomes in future outbreaks.
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Affiliation(s)
- Eva Zhang
- Department of Medicine, Macquarie University, Macquarie Park 2113, Australia
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
| | - Britt Christensen
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
- Department of Medicine, University of Melbourne, Melbourne 3050, Australia
| | - Finlay Alistair Macrae
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne 3050, Australia
- Department of Medicine, University of Melbourne, Melbourne 3050, Australia
- Department of Colorectal Medicine, Royal Melbourne Hospital, Melbourne 3050, Australia
| | - Rupert Leong
- Department of Medicine, Macquarie University, Macquarie Park 2113, Australia
- Department of Gastroenterology, Concord Repatriation General Hospital, Concord 2137, Australia
- Correspondence:
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