P032  The Symptomatic and Psychological Impacts of COVID-19 Outbreak on IBD Patients – A Patient Survey in a Tertiary Referral Center

P032  The Symptomatic and Psychological Impacts of COVID-19 Outbreak on IBD Patients – A Patient Survey in a Tertiary Referral Center
 

Feng Minjun1, Stone Molly1, Forster Erin1
1 Medical University of South Carolina, Charleston, United States

BACKGROUND: The World Health Organization declared COVID-19 a pandemic in March 2020. It has been presumed that immunosuppressed people, including Inflammatory Bowel Disease (IBD) patients, are more vulnerable to contracting infection. Additionally, the pandemic is expected to increase levels of fear and anxiety among people due to knowledge gaps and persistent social isolation. However, the effect of COVID-19 on IBD patients remains unknown. We hypothesized COVID-19 would have negative psychological and symptomatic impacts on IBD patients.

METHODS: After obtaining IRB approval, we identified IBD patients with at least one clinic visit at MUSC IBD Center in the past 5 years and invited them to participate in a brief anonymous survey via REDCAP.

RESULTS: We invited 1504 eligible patients and received 502 responses (Crohn’s disease [CD]=331, ulcerative colitis [UC]=140) from June to July 2020. A total of 238 (72%) CD patients and 88 (63%) UC patients felt more anxious since the outbreak and had a significantly higher rate of symptom worsening compared to patients who were not anxious (32% vs 8%, N=502, p < 0.05). Additionally, many (79% CD and 68% UC) patients were worried they were more vulnerable to COVID-19 infection, but only approximately half (54% CD and 42% UC) discussed their concerns with their health care providers (HCP). Patients who discussed their concerns had a higher rate of feeling supported compared to those who did not (92% vs 70%, N=484, p < 0.05). Interestingly, patients who felt supported had a lower rate of developing worsening of IBD symptoms compared to those who felt unsupported (21% vs 34%,N=482, p < 0.05). Increase in bowel movement frequency (n=96) and abdominal pain level (n=89) were the two most common complaints. Sixty three percent of patients who reported worsening of disease spoke with their HCP about changes. Patients’ anxiety or decision to not talk to HCP were not explained by changes in health insurance as 99% of patients reported COVID did not affect rates of coverage. A small portion of patients (7%) reported changes to their medications/dosing since the outbreak, mostly due to worsening of symptoms. Approximately 30% of patients reported changes in eating habits since the outbreak. In free response (N=145), 47% of them reported “healthier” changes (e.g. more vegetable & fruits), 13% indicated eating “worse”(e.g. more junk food) with another 40% neutral, though there was not a significant difference in symptom worsening (24% vs.32%, N=87, p=0.47).

CONCLUSION(S): Our results indicate the COVID-19 outbreak had negative psychological and symptomatic impacts on IBD patients. Patients with CD were more likely to experience COVID-related anxiety compared to patients with UC. Those who stressed about COVID were more likely to experience worsening of IBD symptoms. Patients who discussed the pandemic with their HCP were more likely to feel supported and less likely to experience symptom worsening, although many who experienced symptom worsening did not talk to their HCP. Around one-third of patients reported changes in eating habits, but this was not correlated with symptom worsening. Longer term data on COVID effects on IBD patients are needed.