IDDF2023-ABS-0032 Active inflammatory bowel disease is associated with severe covid-19: a systematic review and meta-analysis

IDDF2023-ABS-0032 Figure 1 IDDF2023-ABS-0032 Figure 2 IDDF2023-ABS-0032 Figure 3 IDDF2023-ABS-0032 Figure 4COVID-19 outcomes in moderate-severe vs mild or quiescent IBD[Figure omitted. See PDF]ConclusionsPatients with IBD, particularly UC had an increased risk of developing severe COVID-19. Active IBD is associated with adverse COVID-19 outcomes, and the risk is increased with the disease activity of IBD.

Young persons and healthcare professionals experience of virtual gastroenterology consultations: a multicentre survey conducted during the COVID-19 pandemic

ObjectiveTo explore Young Persons (YP) and healthcare professionals (HCP) experiences of virtual consultations (VC) and establish whether developmentally appropriate healthcare can be delivered virtually.MethodYP and HCP questionnaire surveys were designed and piloted. Electronic questionnaire links were sent by post, email or text message January–April 2021 to YP aged 13–25 years old, with predefined chronic gastrointestinal conditions, attending a gastroenterology/hepatology VC. HCP undertaking VC were invited to complete staff questionnaire. Results were anonymous and collated using Excel version 2302.ResultsFive UK hospital trusts participated, with 35 HCP responses. Of the 100 YP completing the survey 66% were female and 34% male aged between 13 years and 25 years (median: 18 years). 13% were new appointments and 87% follow ups, 29% were by video, 69% by phone and 2% gave no response. 80% of HCP spoke to YP directly but not privately (69%). 87% of YP and 88% HCP found VC useful. 83% of YP want VC again, although 20% preferred face to face. 43% of HCP required improved phone/internet connection. 77% of YP required hospital appointments for tests following VC.ConclusionsOverall respondents were satisfied with VC, finding them useful, convenient and time saving. Successful VC rely on appropriate patient selection and availability of reliable technology. Patient preference is key which may alter with time.

IDDF2023-ABS-0282 Prevalence and risk factors for unhealthy dietary habits among children during covid-19 pandemic

BackgroundThe COVID-19 pandemic has led to changes in dietary and lifestyle habits among children and adolescents. This study investigated the prevalence and factors associated with unhealthy dietary habits among 1,475 primary and secondary school students from 2021 to 2022.MethodsA cross-sectional study was conducted in randomly selected primary and secondary schools participating in a project promoting online health education and promotion named GoSmart using self-administered questionnaires. Logistic regression analyses were conducted to investigate the demographic and lifestyle habits associated with various unhealthy dietary habits. This study was approved by Survey and Behavioural Research Ethics (SBRE) [Reference No.: SBRE-21-0052] and funded by Quality Education Fund (QEF#2019/0883).ResultsThe prevalence of inadequate consumption of vegetables and fruits was high among both primary (81.5%) and secondary school students (89.5%) and associated with physical inactivity in both primary (aOR=3.35, 95%CI: 1.41-7.97, p=0.006) and secondary students (aOR=4.30, 95%CI: 1.51-12.25, p=0.006). A substantial prevalence of breakfast skipping was observed among primary students (22.9%) who spent two or more hours on video games or social media (aORs=1.84-2.27);and among secondary students (23.7%) who consumed two or more hours on social media, alcohol consumption, and consumption of unhealthy food (aORs=1.42-2.79). Consumption of unhealthy food was reported by 43.9% and 48.2% for primary and secondary students respectively, with primary and secondary students who spent two or more hours on video games or social media (aORs=1.62-2.27) and secondary students who perceived themselves as underweight (aOR=1.79, 95%CI: 1.13-2.83, p=0.012) having a higher frequency of consumption.ConclusionsThere was a high prevalence of unhealthy dietary habits among schoolchildren in Hong Kong. Alarming results were observed with physical inactivity being associated with a higher risk of unhealthy dietary habits among primary and secondary students, which may increase the risk of obesity. Moreover, the apparent interrelationship between unhealthy habits highlights the need for a comprehensive approach to promoting healthy habits through education in this population.

IDDF2023-ABS-0005 Hepatocellular carcinoma (HCC) treatment experience using smart fusion in dialysis patients

BackgroundApproximately 700 dialysis patients are seen at our hospital. Among them are patients with HCC that develop viral hepatitis. Advances in ultrasound systems have improved the accuracy of HCC treatment and diagnosis. This time, we had the opportunity to use microwaves for dialysis patients using Smart Fusion and needle navigation installed in APLIOi800 so that we will report it.MethodsTen dialysis patients were treated from January 2018 to February 2023. An Emprint (Covidien, USA) antenna was used for treatment. Canon APLIOi800(Canon, Tochigi, Japan) was used. The built-in function is Smart Fusion. This method can display ultrasound imaging and volume data from other modalities, such as CT and MRI, in association with positional information using a magnetic sensor. Needle navigation has a function that can confirm the position of the needle. It is possible to treat even when the tumor is overprinted and the visualization is poor due to bubbles. Informed consent was obtained from all patients and the treatment was performed.ResultsIt was possible to visualize all tumors. In this study, CT images were used in 0 cases, and MRI was used in 1 Case. No serious side effects occurred after treatment.ConclusionsUsing this method, it was thought that dialysis patients could be safely and accurately treated.

IDDF2023-ABS-0156 Poor tolerance of bowel preparation for index colonoscopy decreases surveillance rate in high-risk adenoma removal patients

IDDF-2023-ABS-0156 Table 1Association between Tolerance of BP for index colonoscopy and surveillance rateTolerance of BP for index colonoscopy Surveillance rate% (n/N) Total 67% (127/186) 1. Very intolerable 47% (9/19) 2. Intolerable 48% (10/21) 3. Neither tolerable nor intolerable 76% (55/72) 4. Tolerable 71% (22/31) 5. Very tolerable 72% (31/43) P for trend test 0.04 IDDF2023-ABS-0156 Table 2Risk factors of non-compliance of surveillance colonoscopy by multivariate regression analysis Multivariate OR (95%CI) p value Age,/1-year increase 1.04 (1.03-1.05) 0.001 Male sex 1.13 (0.85-1.52) 0.40 BMI,/1-kg/m2 increase 1.05 (0.96-1.15) 0.28 Family history of CRC 0.93 (0.16-5.25) 0.92 Low education 0.92 (0.39-2.15) 0.90 Comorbidities 1.05 (0.51-2.13) 0.90 Low tolerance of BP for colonoscopy 2.45 (1.11-5.41) 0.006 Absence of primary care physician 4.63 (1.60-13.4) 0.001 BMI: body mass index, CRC: colorectal cancer, BP: bowel preparation IDDF2023-ABS-0156 Table 3The reasons of non-compliance surveillance colonoscopyReasons of non-compliance surveillance colonoscopy n, (%) Total 62 (100%) Not knowing about follow-up intervals 4 (6%) Having no symptoms 15 (24%) Fear of examination Pain during colonoscopy 1 (2%) Embarrassment during colonoscopy 0 (0%) Bowel preparation for colonoscopy 17 (28%) Over sedation during colonoscopy 2 (3%) Old age/severe illness for surveillance 10 (16%) Having no time 10 (16%) Having no money 1 (2%) Fear of Covid-19 infection 2 (3%) IDDF2023-ABS-0156 Figure 1ConclusionsOur findings highlight the need for improvement of the surveillance colonoscopy rate, especially for patients who had poor tolerance to BP on index colonoscopy and no gastroenterology visit. Providing a well-tolerated BP regimen may lead to an increase in surveillance colonoscopy compliance.

IDDF2023-ABS-0045 Spatiotemporal immune landscape of Mas-driven pro-inflammatory microenvironment with hyperactivated glycolysis in acetaminophen-induced liver injury

IDDF2023-ABS-0045 Figure 1 IDDF2023-ABS-0045 Figure 2 IDDF2023-ABS-0045 Figure 3 IDDF2023-ABS-0045 Figure 4

IDDF2023-ABS-0299 Effectiveness of relink initiatives to re-engage diagnosed-but-untreated HCV-positive patients with direct-acting antiviral treatment

BackgroundHepatitis C virus (HCV) infection is a major cause of chronic liver disease that can progress to cirrhosis and hepatocellular carcinoma. The WHO has identified HCV infection as a public health threat and set a global target for HCV elimination by 2030. Simple pangenotypic direct-acting antiviral regimens allow most patients to be cured with minimal pretreatment and on-treatment monitoring. To achieve the WHO goal, patients including previously diagnosed HCV-positive patients who have been lost to follow-up, need to be linked to care. Studies report that up to 60% of patients who test positive for HCV antibodies are lost to follow-up and not treated. This loss has been further exacerbated by the COVID-19 pandemic, and many patients put off receiving care. Here, we explore the effectiveness of care re-engagement programs for patients with HCV.MethodsWe assessed ReLink programs (sponsored by Gilead Sciences, Inc.), designed to identify and re-engage HCV-positive patients with medical care and start/restart HCV treatment. We evaluated these programs by analyzing the number of patients, steps in the care cascade where patients were lost to follow-up, and the efficacy of the engagement program (determined by the number relinked and treated).ResultsSix programs assessed 44,964 patient records, identifying 11,163 patients lost to follow-up and eligible for contact. The main reason for the loss of follow-up was the inability to contact patients. Overall, 3726 patients were relinked with care, and 701 were treated. Several key points were identified for improving patient engagement with care, including the use of electronic databases to identify patients lost to follow-up, securing reliable contact information for patients, and partnership with medical societies.ConclusionsActive case finding, patient navigation, and care coordination in these programs led to increased engagement and treatment rates. Engaging HCV-positive patients with care is urgent, as many may already have developed more advanced liver disease. Adopting and adapting effective strategies from these programs may be a feasible way to improve patient outcomes and increase treatment numbers, thus contributing to meeting the WHO goal of HCV elimination.

Severe Acute Pancreatitis Associated with Weil's Disease

Leptospirosis is an emerging zoonosis of worldwide importance. Its distribution is closely linked to hydrometric conditions. It is characterized by a wide clinical range, from the subclinical form, or one with few symptoms;which resolves spontaneously, to the multi-visceral form, known as icterrohemorrhagic disease or Weil's disease, with a lethal risk. All organs can be affected but with variable frequency. Pancreatic involvement is not well documented. We describe a 45-year-old man with Weil's disease associated with acute necrotizing pancreatitis. The evolution was favorable but required a three-week stay in the intensive care unit.

Abdominal Imaging Findings in Patients with COVID-19 Part 2: Solid Organs

[...]although solid abdominal organs are rarely affected by COVID-19, clinicians must be familiar with the manifestations since they are associated with the disease severity and poor outcome. Keywords: COVID-19, Abdominal, Imaging, Computed tomography, Ultrasonography Introduction The world has been confronting the upsurge of coronavirus disease 2019 (COVID-19) since the first novel coronavirus infection (SARS-CoV-2) initially emerged in China in December 2019.1 The most common symptoms reported in COVID-19 are related to respiratory system involvement, including fever, dry cough, fatigue, and dyspnea.2 Angiotensin-converting enzyme 2 (ACE2) plays a significant role in mediating the inflammation of COVID-19, which can contribute to COVID-19 manifestations.3 ACE2 receptors are found in various cells, including hepatocytes, cholangiocytes, podocytes, and enterocytes.2,3 Forty percent of infected patients have shown gastrointestinal (GI) manifestations, including loss of taste, nausea, vomiting, diarrhea, and abdominal pain.4 A significant number of patients have GI symptoms, and sometimes it is the only presentation of the disease without respiratory manifestations.2 The reverse-transcriptase polymerase-chain-reaction (RT-PCR) diagnostic test and chest computed tomography (CT) were reported to be highly sensitive in the early diagnostic stage of suspected COVID-19.5 Cross-sectional abdominal imaging is not usually used in COVID-19.6 Nevertheless, abdominal CT may be performed if specific symptoms exist, such as abdominal pain. Radzina et al found that multiparametric ultrasonography may be more sensitive than CT and Magnetic resonance imaging in assessing liver damage at the cellular level in patients with COVID-19 before progressing into liver cirrhosis.37 Pancreas Given the fact that ACE2 receptors are vastly expressed in pancreatic islet cells, COVID-19 can induce islet cell damage presenting with acute diabetes.38 The pancreatic involvement can occur through the direct invasion by SARS-CoV2, a systemic response to pneumonia, or a destructive immune reaction due to viral stimulation.19 According to Wang and colleagues, the pancreas was affected in 17% of patients with COVID-19 pneumonia.19 In reported cases of SARS-CoV-2 infection, abdominal CT revealed features of acute pancreatitis, including edema and inflammation of the pancreas with surrounding fluid collections and fat stranding30-39 (Figure 3). Kidney According to Pei et al, the most prevalent renal abnormalities in the setting of COVID-19 were proteinuria and hematuria, with acute kidney injury (AKI) happening less often.50 Renal infarct might occur because of hypercoagulation.6 The possible mechanisms of AKI in COVID-19 might be related to a variety of factors, including cytokine release syndrome, hypoxia, endotoxin produced by superimposed infections during ICU admission, and rhabdomyolysis.51 Different studies have established that AKI considerably increased the mortality rate in admitted patients with COVID-19.20 Renal parenchymal hypodensity and perirenal fat stranding on non-enhancement CT in patients with COVID-19 represent severe renal impairment.52 Like the spleen, the most common renal finding in abdominal tomograms was infarction.12 In such conditions, the affected kidney presents with patchy, sharply demarcated heterogeneous areas with hypoenhancement.6 A summary of renal imaging findings is shown in Table 6.