Study of Inflammatory Bowel Disease in Ethnic Groups and the Impact of the COVID-19 Pandemic

ABSTRACT

Background: Impact of the COVID-19 pandemic on disease management and progression of inflammatory bowel disease (IBD) in various ethnic groups is not known. We aimed to study the prevalence of IBD in various ethnic groups and the impact of the COVID-19 pandemic. The objectives of the study were to determine severity of IBD and compliance in various ethnic groups, to compare status at follow-up before the pandemic and recent follow-up during the pandemic. Design: Our records were queried from 2017 to 2021 for diagnostic terms related to inflammatory bowel disease. Retrospective chart review was performed of the cases found in the search results to determine diagnosis of inflammatory bowel disease. Relevant clinicopathological parameters were recorded including status at follow-up before the pandemic and most recent follow-up during the pandemic. Results: Total of 350 patients with inflammatory bowel disease included 232 White and 118 Black patients with a mean age of 43 years and 36 years respectively. Crohn's disease (CD) was found to be more common than ulcerative colitis (UC), only 5 cases of indeterminate colitis were noted, Table. In both UC and CD, more Black patients presented with anemia and emergency department (ED) visits. Overall Black patients had lower compliance to medication and follow-up appointments, Table. Loss of insurance was most frequently mentioned as the reason for loss of compliance. In CD, Black patients presented with greater severity of disease in the form of more ED visits, hospital admissions, duration of hospital stays, IBD related surgeries, Table. During the pandemic compliance for follow-up appointments significantly decreased for all patients (from 83% to 58% in White patients and from 69% to 48% in Black patients respectively), (p<0.001). No SARS-CoV-2 infection related exacerbation of IBD was reported. Conclusions: Socioeconomical factors and the COVID-19 pandemic influenced access to healthcare and progression of IBD. Reduced compliance to follow-up was noted in all ethnic groups during the pandemic. Greater severity of disease especially in case of CD, and lower compliance to medication in the Black population were noted. No exacerbation of IBD was reported due to SARS-CoV-2 infection.