Impact of Covid-19 on Pediatric Ibd Patients Receiving Infusions

ABSTRACT

As the SARS-CoV-19 pandemic continues in the United States, it has become evident that people of all ages are affected. Overall, children typically have a mild course of illness when infected with COVID-19. Available literature reports that children with IBD are not at a higher risk of contracting COVID-19 when compared to the general population, however, research is limited. Our study explored the COVID-19 pandemic in relation to pediatric IBD patients as there are significant knowledge gaps in incidence, association, and effect on the mental health of the patient, and outcome of COVID -19 in these populations. It is widely known that adult patients with comorbidities are at a higher risk for developing a more severe COVID-19 disease course. An international pediatric and adult database collecting data on COVID-19 in IBD patients named the Surveillance Epidemiology of Coronavirus Under Research Exclusion (SECURE-IBD), has been monitoring outcomes of patients with IBD that were COVID-19 positive. In a study published in 2021, data from 209 children and adolescents showed a 7% hospitalization rate among pediatric IBD patients who tested positive for COVID-19, a rate much lower than the overall hospitalization rate of adult IBD patients with COVID-19. Factors that resulted in hospitalization included comorbid conditions, steroid use, moderate to severe IBD, and specific GI symptoms from COVID-19. Similarly, a study published in 2021 consisting of 290 pediatric IBD patients revealed only a minority of IBD patients had mild symptoms, and none of them required hospitalizations or treatment modification. We attempted to look into the impact of Covid-19 in our patients receiving infusions at the hospital infusion center. We offered a survey to 39 patients in our infusion center, 32 of which were included in our analysis. 4 patients refused to take part in the study, 1 consent form was not signed, and 2 were excluded for being older than 21 years of age. The majority of these patients received infliximab/Remicade infusions. Males-44%,females-56%. 72%-Crohn's disease, 28% -Ulcerative colitis. None of the patients required any specific treatments or hospitalizations based on survey responses. 3 patients required ER visits and no changes in medications were made in IBD management due to covid-19. 1 patient required a change in the schedule of the infusion due to Covid-19 symptoms. About 66% of patients either received the vaccine or intended to take it if eligible at the time of the survey. With continued research data on the safety and efficacy of vaccination, we expect this number will go up. While there was some anxiousness reported about the Covid-19 pandemic, there was a negative trend seen in the mood and feeling questionnaire across all questions (table 2). Overall, our study confirmed that the covid-19 pandemic so far had minimal impact on IBD management but identified a need to improve mental health for overall quality of life. Our study was only limited to patients receiving infusions at our hospital which leaves a significant number of patients receiving other modes of therapy or home infusions for IBD. Further ongoing research will be needed to identify the long-term impact of Covid-19 on IBD patients on a larger scale.