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Impact of COVID-19 on diagnosis and management of paediatric inflammatory bowel disease during lockdown: a UK nationwide study.
Ashton, James John; Kammermeier, Jochen; Spray, Christine; Russell, Richard K; Hansen, Richard; Howarth, Lucy J; Torrente, Franco; Deb, Protima; Renji, Elizabeth; Muhammed, Rafeeq; Paul, Thankam; Kiparissi, Fevronia; Epstein, Jenny; Lawson, Maureen; Hope, Ben; Zamvar, Veena; Narula, Priya; Kadir, Ahmed; Devadason, David; Bhavsar, Hemant; Beattie, Robert Mark.
  • Ashton JJ; Department of Paediatric Gastroenterology, Southampton Children's Hospital, Southampton, UK.
  • Kammermeier J; Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK.
  • Spray C; Department of Paediatric Gastroenterology, Evelina London Children's Hospital, London, UK.
  • Russell RK; Department of Paediatric Gastroenterology, Bristol Royal Childrens Hospital, Bristol, UK.
  • Hansen R; Department of Paediatric Gastroenterology, The Royal Hospital for Sick Children, Edinburgh, UK.
  • Howarth LJ; Department of Paediatric Gastroenterology, Royal Hospital for Children Glasgow, Glasgow, UK.
  • Torrente F; Department of Paediatric Gastroenterology, Oxford University Hospitals, Oxford, UK.
  • Deb P; Department of Paediatric Gastroenterology, Addenbrookes Hospital, Cambridge, UK.
  • Renji E; Department of Paediatric Gastroenterology, The Royal London Hospital, Barts Health NHS Trust, London, UK.
  • Muhammed R; Department of Paediatric Gastroenterology, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK.
  • Paul T; Department of Paediatric Gastroenterology, Birmingham Children's Hospital, Birmingham, UK.
  • Kiparissi F; Department of Paediatric Gastroenterology, St. Georges University Hospital NHS Foundation Trust, London, UK.
  • Epstein J; Department of Paediatric Gastroenterology, Great Ormond Street Hospital, London, UK.
  • Lawson M; Department of Paediatric Gastroenterology, Chelsea and Westminster Hospital, London, UK.
  • Hope B; Department of Paediatric Gastroenterology, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
  • Zamvar V; Department of Paediatric Gastroenterology, King's College London, London, UK.
  • Narula P; Department of Paediatric Gastroenterology, Leeds Children's Hospital, Leeds, UK.
  • Kadir A; Department of Paediatric Gastroenterology, Sheffield Children's NHS Foundation Trust, Sheffield, UK.
  • Devadason D; Department of Paediatric Gastroenterology, Manchester Children's Hospital, Manchester, UK.
  • Bhavsar H; Department of Paediatric Gastroenterology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
  • Beattie RM; Department of Paediatric Gastroenterology, University Hospitals of Leicester NHS Trust, Leicester, UK.
Arch Dis Child ; 105(12): 1186-1191, 2020 12.
Article in English | MEDLINE | ID: covidwho-690253
ABSTRACT

BACKGROUND:

COVID-19 has impacted on healthcare provision. Anecdotally, investigations for children with inflammatory bowel disease (IBD) have been restricted, resulting in diagnosis with no histological confirmation and potential secondary morbidity. In this study, we detail practice across the UK to assess impact on services and document the impact of the pandemic.

METHODS:

For the month of April 2020, 20 tertiary paediatric IBD centres were invited to contribute data detailing (1) diagnosis/management of suspected new patients with IBD; (2) facilities available; (3) ongoing management of IBD; and (4) direct impact of COVID-19 on patients with IBD.

RESULTS:

All centres contributed. Two centres retained routine endoscopy, with three unable to perform even urgent IBD endoscopy. 122 patients were diagnosed with IBD, and 53.3% (n=65) were presumed diagnoses and had not undergone endoscopy with histological confirmation. The most common induction was exclusive enteral nutrition (44.6%). No patients with a presumed rather than confirmed diagnosis were started on anti-tumour necrosis factor (TNF) therapy.Most IBD follow-up appointments were able to occur using phone/webcam or face to face. No biologics/immunomodulators were stopped. All centres were able to continue IBD surgery if required, with 14 procedures occurring across seven centres.

CONCLUSIONS:

Diagnostic IBD practice has been hugely impacted by COVID-19, with >50% of new diagnoses not having endoscopy. To date, therapy and review of known paediatric patients with IBD has continued. Planning and resourcing for recovery is crucial to minimise continued secondary morbidity.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / Child Health Services / Endoscopy, Gastrointestinal / Tumor Necrosis Factor Inhibitors / COVID-19 / Health Services Accessibility Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Arch Dis Child Year: 2020 Document Type: Article Affiliation country: Archdischild-2020-319751

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Inflammatory Bowel Diseases / Child Health Services / Endoscopy, Gastrointestinal / Tumor Necrosis Factor Inhibitors / COVID-19 / Health Services Accessibility Type of study: Cohort study / Diagnostic study / Experimental Studies / Observational study / Prognostic study / Qualitative research Limits: Adolescent / Child / Female / Humans / Male Country/Region as subject: Europa Language: English Journal: Arch Dis Child Year: 2020 Document Type: Article Affiliation country: Archdischild-2020-319751