ABSTRACT
BACKGROUND: Given the increasing health concerns for patients with inflammatory bowel disease (IBD), amidst the COVID-19 pandemic, we investigated the impact of the pandemic on the anxiety and behavioral changes in Japanese patients with IBD. METHODS: We analyzed 3032 questionnaires from patients with IBD, aged 16 years or older visiting 30 hospitals and 1 clinic between March 2020 and June 2021. The primary outcome was the score of the anxiety experienced by patients with IBD during the pandemic. RESULTS: Participants reported a median age of 44 years; 43.3% of the patients were women. Moreover, 60.6% and 39.4% were diagnosed with ulcerative colitis and Crohn's disease, respectively, with a median disease duration of 10 years. Participants indicated an average of disease-related anxiety score of 5.1 ± 2.5 on a ten-point scale, with a tendency to increase, 1 month after the number of infected persons per population increased. The top three causes for anxiety were the risk of contracting COVID-19 during hospital visits, SARS-CoV-2 infection due to IBD, and infection by IBD medication. Factors associated with anxiety were gender (women), being a homemaker, hospital visit timings, mode of transportation (train), use of immunosuppressive drugs, and nutritional therapy. Most patients continued attending their scheduled hospital visits, taking their medications, experienced the need for a family doctor, and sought guidance and information regarding COVID-19 from primary doctors, television, and Internet news. CONCLUSIONS: Patients with IBD experienced moderate disease-related anxiety due to the pandemic and should be proactively informed about infectious diseases to relieve their anxiety.
Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Adult , Female , Humans , Male , Anxiety/epidemiology , Anxiety/etiology , COVID-19/epidemiology , East Asian People , Inflammatory Bowel Diseases/complications , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/therapy , PandemicsABSTRACT
Introduction: This study assessed changes in patients transported to an emergency and critical care center before and after the coronavirus disease 2019 (COVID-19) pandemic in Japan and examined problems that should be addressed in emergency medical care. Methods: This single-center retrospective observational study was conducted at a university hospital. The subjects were patients who were transported to a "tertiary emergency department" receiving advanced medical care. With January 16, 2020, as the cutoff date, 4,197 patients who were transported to the hospital from January 16, 2019, to January 15, 2021, were recruited. The patients were classified into nine disease groups using the International Classification of Diseases, Tenth Revision. The emergency department (ED) visit count in 2020 was compared with that in 2019 using Poisson regression. Results: The number of patients transported to the tertiary ED in 2020 decreased by 7.8% compared with that in 2019. The number of patients transported to the tertiary ED decreased compared with that in the previous year during the period when the number of confirmed COVID-19 cases in Japan increased and showed the opposite trend when the number of confirmed cases decreased. As per diagnostic classification, it decreased for all diagnoses except External causes, and significant decreases were observed in Infectious (47.5%), Non-COVID-19 respiratory (28.4%), and Trauma (25.2%). In External causes, the rate of change for suicide cases alone increased to 43.2%. Conclusions: While the number of confirmed cases increased, the number of tertiary ED patients associated with COVID-19 decreased temporarily. It is necessary to fully consider the burden on medical institutions 1-2 months after the number of infected people peaks. It is also necessary to closely monitor suicides associated with COVID-19 as a factor that will cause changes in emergency medical care in the future.