Impact of the COVID-19 pandemic on inflammatory bowel disease care in Taiwan: A multicenter study

Abstract

The coronavirus disease 2019 (COVID-19) pandemic had a great impact on healthcare system and patients. This study aimed to evaluate the effect of the COVID-19 pandemic on the perceptions of patients with inflammatory bowel disease (IBD). This prospective multicenter study was conducted between July 2021 and December 2021. Patients with IBD answered a structured questionnaire, and their degree of anxiety was assessed using a visual analogue scale (VAS) before and after reading educational materials. A total of 225 (47.67%) patients with Crohn's disease, 244 (51.69%) with ulcerative colitis and 3 (0.64%) with indeterminate colitis were enrolled. Common concerns were adverse events from vaccination (20.34%), and higher risks of developing severe COVID-19 (19.28%) and COVID-19 infection (16.31%) than the general population. Medications deemed by the patients to increase the risk of COVID-19 were immunomodulators (16.10%), anti-tumor necrosis factor-α antagonists (9.96%), and corticosteroids (9.32%). Thirty-five (7.42%) patients self-discontinued IBD medication, of whom 12 (34.28%) had worse symptoms. Older age (>50 years) (OR 1.10, 95% CI 1.01-1.19, p=0.03), IBD-related complications (OR 1.16, 95% CI 1.04-1.28, p=0.01), education status below senior high school (OR 1.22, 95% CI 1.08-1.37, p=0.001), and residing in north-central Taiwan (OR 1.21, 95% CI 1.10-1.34, p<0.001) were associated with more anxiety. None of the enrolled patients contracted COVID-19. The anxiety VAS score (mean±SD) improved after reading the educational materials (3.84±2.33 vs. 2.81±1.96, p<0.001). The medical behavior of IBD patients was influenced by the COVID-19 pandemic, and their anxiety could be mitigated after education.