P075  SARS-CoV-2 Testing and Exacerbations in IBD Patients during the COVID Pandemic: A Single Center Study

P075  SARS-CoV-2 Testing and Exacerbations in IBD Patients during the COVID Pandemic: A Single Center Study

 

Houle Matthew1, Hennessey Megan1, Atienza Matthew1, Rao Sanjana1, Borum Marie1
1 George Washington University School of Medicine, Washington, United States

BACKGROUND: The impact of SARS-CoV-2 infection upon patients with inflammatory bowel disease (IBD) is incompletely understood. Diagnostic testing for SARS-CoV-2 is increasingly incorporated into medical practices for early identification of infection and contact tracing. There have also been concerns raised about SARS-CoV-2 risk and complications in IBD. However, there are few studies that have assessed the influence of the COVID pandemic upon IBD. This study evaluated reasons for SARS-CoV-2 testing in IBD patients and the frequency of IBD exacerbations during the pandemic.

METHODS: A retrospective chart review of all IBD patients at an urban academic medical center seen in the past 3 years was performed. There were no exclusion criteria. Patient gender, age, race, disease subtype, medication regimen, SARS-CoV-2 testing and exacerbations were obtained. A confidential database was created using Microsoft Excel. Statistical analysis was performed using Fisher’s exact test with significance set at p<0.05. The study was IRB approved.

RESULTS: 291 medical records of consecutive IBD patients were evaluated. There were 126 (43.3%) males, 165 (56.7%) females, with a mean age of 45.5 years. 152 patients were white, 83 African-American, 24 Hispanic and 22 with their race not documented. 74 (25.4%) had Crohn’s disease, 206 (70.8%) had ulcerative colitis, 6 (2.1%) had microscopic colitis, and 5 (1.7%) had indeterminate colitis. 41 (14.1%) of the IBD patients were tested for SARS-CoV-2 by a provider at the university.  There was no difference in SARS-CoV-2 testing based upon race (p=1.000), disease subtype (p=0.4491) or medication regimen (p=0.5814). The most common reasons for testing included colonoscopy requirement (34.1%), asymptomatic testing request (17.1%), possible SARS-CoV-2 symptoms (14.6%), urgent inpatient procedure (12.2%) and elective procedure (7.3%). 40 (97.6%) patients tested negative and 1 (2.4%) patient tested positive.  26 (8.9%) patients had exacerbations with 8 requiring hospitalization. There was a significant difference in the rate of exacerbation based upon subtype (17.6% Crohn’s vs 6.7% ulcerative colitis; p=0.0091). There was no significant difference in the rate of exacerbations based upon gender (p=1.000) or ethnicity (p=0.1203).

CONCLUSION(S): There were multiple reasons for SARS-CoV-2 testing, with some that may be specific for individuals with IBD. In this study, >50% of IBD patients had SARS-CoV-2 testing as a requirement prior to colonoscopies or other procedures. However, it is important to recognize that >30% of IBD patients were tested due to SARS-CoV-2 infection concerns, with only 1 patient testing positive. Few patients had exacerbations during the SARS-CoV-2 pandemic, with exacerbations occurring more often in patients with Crohn’s disease. While this study is limited due to single institutional design and size, it offers a foundation for further research to determine if IBD patients have greater apprehension or worse outcomes due to SARS-CoV-2 infection compared to others with chronic illness.