S0727 COVID-19 Impact on IBD Patients in a Tertiary Care IBD Program

Abstract

INTRODUCTION: Impact of the novel Coronavirus (SARS-CoV-2) is evolving as we come to understand its influence on disease states Further understanding of the pandemic's influence on inflammatory bowel disease (IBD) patients is needed This study characterizes the course of IBD patients during the 1st wave of the COVID-19 pandemic with special attention to exposures, symptoms and testing METHODS: A retrospective chart review was performed between March 1, 2020 and June 1, 2020 on established actively managed IBD patients IBD patients with CDC classified symptoms, known SARS-CoV-2 exposure or with SARS-CoV-2 testing were included SARS-CoV-2 testing was an institution-validated nasal swab for COVID-19 Coronavirus PCR IBD treatment and disease characteristics were recorded Patients under suspicion were managed through institution-specific triage followed by evaluation and testing Medication changes and treatments were collected RESULTS: 37 of current 909 active chronic care patients were included with a mean age of 41 ± 15 9 and 48 6% females (Table 1) 52 8% had Crohn's disease while 47 2% had ulcerative colitis Compared to the 513 (56%) of the total 909 on IBD immunosuppression, 78% of our study cohort were on either biologics or immunomodulators (P = 0 017) 13 5% of these patients tested positive for SARS-CoV-2, 18 9% had known exposure and 62 1% had symptoms concerning for infection with diarrhea as most common (36 4%) 3 (8 1%) patients were on steroids at time of presentation and only 1 tested positive There were 0 hospitalizations required for COVID management and none were treated with hydroxychloroquine 60% of patients who were SARS-CoV-2 positive required changes to their IBD medication regimen (Table 2) CONCLUSION: SARS-CoV-2 disproportionately affected our immunosuppressed IBD patients;however all were safely managed without need for hospitalization, imaging, or colonoscopy Proto-colized health system triage was also effective in identifying IBD patients for testing early Despite studies supporting IBD patients having increased intestinal ACE-2 expression, an enzyme implicated in the inflammatory pathway affected by SARS-CoV-2, many reports suggest lower rates of severe COVID-related outcomes in IBD patients, which may be suggested in our current observations Ongoing studies are crucial to identify IBD patients at risk for adverse COVID-19 outcomes, optimize infectious complications in immunosuppressed IBD patients and evaluate the impact of targeted immunomodulation on IBD outcomes