Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, immunomodulatory therapies and hospital admission were suspected to increase the risk of infection. Nevertheless, patients with inflammatory bowel diseases (IBD) treated with intravenous (i.v.) biologics had to move to hospitals for drug infusion. We investigated the impact of hospitalisation in patients with IBD. We conducted a survey including consecutive IBD patients initially in clinical and biochemical remission treated with biologics at the end of the first lockdown period. Patients underwent the normally scheduled clinical visits, performed at hospital for i.v.-treated patients or at home for patients treated with s.c. drugs. We administered to all patients the Hospital Anxiety and Depression Scale (HADS) questionnaire and other 12 questions, specifically related to COVID-19 and its implications. A total of 189 IBD patients were recruited, 112 (59.3%) treated with i.v. drugs and 77 (40.7%) with s.c. ones. No relapses were recorded in either group (hospitalized vs. non-hospitalized, p = ns), as well as which, COVID-19 infections were not demonstrated in patients in contact with people with suspected symptoms or directly experiencing them. The total HADS score obtained by the sum of all items was also almost identical between groups (37.1 ± 2.8 vs. 37.2 ± 2.8; p = 0.98). In patients treated with i.v. drugs receiving a televisit (n = 17), the rate of satisfaction with telemedicine (58.8%) was significantly lower compared with those treated with s.c. drugs (94.8%; p < 0.0005). Our results suggest that hospitalisation during the COVID-19 outbreak does not increase the risk of COVID-19 infection as well as the risk of IBD relapse; moreover, the similar levels of anxiety in both groups could confirm that there is no need to convert patients from i.v. to s.c. therapy.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic has revolutionized our habits of life in the last 12 months
At the end of first wave of the COVID-19 pandemic in Italy, in June and July 2020, we conducted a survey including consecutive inflammatory bowel diseases (IBD) patients treated with biologics at three
Clinical remission was defined as a Partial Mayo Score (PMS) < 2 for patients with ulcerative colitis, and as a Harvey–Bradshaw Index (HBI) < 5 for patients with Crohn’s disease
Summary
The coronavirus disease 2019 (COVID-19) pandemic has revolutionized our habits of life in the last 12 months. Home confinement exposed individuals to a stressful situation of unknown duration [2] Broadcasters focalized their program schedules on COVID-19 pandemic, leading to an “infodemic”, which had significant impact on the psychological well-being of the whole population, especially with regard for the access to hospitals [3]. Inflammatory Bowel Diseases (IBD) are chronic disorders of the intestinal tract characterized by relapsing and remitting intestinal inflammation [4,5]. Both diseases are associated with a marked reduction in health-related quality of life, severe fatigue, and work impairment, as well as with depression and anxiety [6,7]. Several studies associated the risk of disease relapse to stressful events [7,8,9]
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