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

Background: 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). Methods: 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. Results: 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 -a 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). Conclusion: The medical behavior of IBD patients was influenced by the COVID-19 pandemic, and their anxiety could be mitigated after education. Copyright 2023, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).

Automated summary

This study evaluated the impact of the COVID-19 pandemic on the perceptions of patients with inflammatory bowel disease (IBD). The results showed that patients were concerned about adverse events from vaccination, higher risks of developing severe COVID-19, and COVID-19 infection compared to the general population. Some patients self discontinued IBD medication during the pandemic, leading to worse symptoms. However, after receiving education, the anxiety levels of the patients were mitigated.