S3355 Inflammatory Bowel Disease (IBD) Patients in Remission at the Time of COVID-19 Diagnosis Have Better IBD Related Outcomes Than Those With Moderate Disease Activity at the Time of COVID-19 Diagnosis

Abstract

Introduction: We aimed to explore IBD related outcomes in a cohort of IBD patients affected by COVID-19. Methods: We performed a retrospective case series of patients with IBD who were diagnosed with COVID-19 and seen in a single tertiary care referral center from March 2020 to March 2021 after IRB approval. COVID-19 diagnosis was made based on a combination of symptoms and positive rapid antigen, PCR test, and/or SARS-CoV-2 antibodies. We assessed the need for escalation in IBD treatment as defined by need for hospitalization, new steroid use, escalation or addition of immunosuppressive maintenance therapy, and/or surgery at 3 months after a diagnosis of COVID-19. Disease activity was estimated based on routinely measured clinical disease severity indices documented in office visit notes and/or routinely measured endoscopic scoring documented in the procedure notes. When such data was not available, disease activity and remission was determined by Physician Global Assessment. Continuous variables were compared between groups using student t test. Categorical variables were compared using Chi square test. Results: We identified 57 eligible patients. At the time of diagnosis, 30 (52.3%) were in remission, 21 (36.8%) had moderate disease activity, and 2 (3.5%) had severe disease activity. A comparison of baseline characteristics and COVID-19 outcomes of those who required escalation of therapy post COVID-19 diagnosis and those who did not are detailed in Table. Patients who did not require escalation in management were more likely to have a higher body mass index and be in remission at the time of COVID-19 diagnosis than those who did require escalation in treatment. Patients who required escalation in treatment were more likely to have moderate disease activity at the time of COVID-19 diagnosis as well as be on corticosteroids including prednisone than those who did not require escalation. IBD patients with moderate disease activity at the time of COVID-19 diagnosis were more likely to need escalation in treatment than those in remission (OR 12; CI 2.75-52.35, P=0.0009). Conclusion: IBD patients in remission at the time of COVID-19 diagnosis did better than those with moderate disease activity in terms of need for additional IBD therapy. Whether the need for escalation of IBD therapies in patients with moderate disease activity is related to the natural progression of the disease or influenced by COVID-19 infection warrants further exploration.Table 1.: Comparison of IBD patients who required escalation of IBD management post COVID-19 diagnosis with those who did not require escalation of IBD therapy post COVID-19 diagnosis.