ABSTRACT
Background: In December Of 2019, Coronavirus Disease 2019 (Covid-19) Emerged In Wuhan. The Government Of Japan Declared A “State Of Emergency” On April 16, 2020. Although This Approach Was Partially Successful For Temporarily Stopping The Spread, Concerns Were Raised Regarding The Negative Impact Of These Measures, Not Only In Terms Of Economics, But Also In Terms Of Mental And Physical Health, Such As Anxiety And Depression. Inflammatory Bowel Diseases (Ibd) Are Intestinal Disorders Affected By Environmental Factors, Such As Sleep, Stress, Diet, And Smoking. Therefore, This Study Aimed To Assess The Effects Of The Covid-19 Pandemic And State Of Emergency On The Lifestyle And Disease Activity Of Patients With Ibd. Methods: We Conducted A Questionnaire Survey In Ibd Patients With Regular Follow-Up At Osaka City University Hospital In Japan, From June 16 To August 21, 2020. The Questionnaire Included Questions Regarding The Patient’S Epidemiological History Of Covid-19, Demographic Data, Gastrointestinal Symptoms, Lifestyle Changes And Stress Related To The State Of Emergency, And Current Medication Use. Gastrointestinal Symptoms Were Assessed Before And During The State Of Emergency Using The 6-Point Mayo Score9 And Patient-Reported Outcome 2 (Pro2) Score10 For Ulcerative Colitis (Uc) And Crohn’S Disease (Cd), Respectively. Results: Overall, 451 Patients Completed The Survey. Patients With Exacerbated Uc Tended Have Younger Age, Less Sleep, And More Stress Against Covid-19 Than Did Patients With Non-Exacerbated Uc. Figure 1 Summarizes The Lifestyle Changes And Stress Related To The State Of Emergency. Patients With Exacerbated Uc Tended Have Younger Age, Less Sleep, And More Stress Against Covid-19 Than Did Patients With Non-Exacerbated Uc. Multivariate Logistic Regression Analysis Identified Younger Age (Odds Ratio [Or] 1.020, 95% Confidence Interval [Ci] 1.010-1.040;P = 0.011), Fewer Sleep Hours (Or 1.320, 95% Ci 1.020-1.720;P = 0.035), And Increased Stress Due To The Covid-19 Pandemic (Or 5.530, 95% Ci 1.650-18.500;P < 0.01) As Independent Risk Factors Associated With Uc Exacerbation During The State Of Emergency. Patients With Exacerbated Cd Had Younger Age At Cd Onset And Had Higher Pro2 Scores Before The State Of Emergency Than Did Patients With Non-Exacerbated Cd. On Multivariate Analysis, Only Younger Age (Or 1.030, 95% Ci 1.010-1.05;P < 0.01) Was Independently Associated With Exacerbation During The State Of Emergency. Conclusions: We Have Showed Data On The Association Between Ibd Activity And Lifestyle Changes / Psychological Stress Due To The State Of Emergency During The Covid-19 Pandemic. This Study Suggests That Improving Sleep Quality And Preventing Psychological Stress Might Be Key In Ibd Management During The Pandemic, Especially In Young Patients. (Figure Presented) (Figure Presented) (Figure Presented) (Figure Presented)