TY - JOUR
T1 - Impact of COVID-19 on diagnosis and management of paediatric inflammatory bowel disease during lockdown
T2 - a UK nationwide study
AU - Ashton, James John
AU - Kammermeier, Jochen
AU - Spray, Christine
AU - Russell, Richard K.
AU - Hansen, Richard
AU - Howarth, Lucy J.
AU - Torrente, Franco
AU - Deb, Protima
AU - Renji, Elizabeth
AU - Muhammed, Rafeeq
AU - Paul, Thankam
AU - Kiparissi, Fevronia
AU - Epstein, Jenny
AU - Lawson, Maureen
AU - Hope, Ben
AU - Zamvar, Veena
AU - Narula, Priya
AU - Kadir, Ahmed
AU - Devadason, David
AU - Bhavsar, Hemant
AU - Beattie, Robert Mark
N1 - Funding Information:
The study was supported by the British Society of Paediatric Gastroenterology, Hepatology and Nutrition IBD working group. JJA is funded by an action medical research training fellowship and by an ESPEN fellowship. RH is supported by a National Health Service Research Scotland Career Researcher Fellowship.
Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020/11/20
Y1 - 2020/11/20
N2 - Background: COVID-19 has impacted on healthcare provision. Anecdotally, investigations for children with inflammatory bowel disease (IBD) have been restricted, resulting in diagnosis with no histological confirmation and potential secondary morbidity. In this study, we detail practice across the UK to assess impact on services and document the impact of the pandemic. Methods: For the month of April 2020, 20 tertiary paediatric IBD centres were invited to contribute data detailing: (1) diagnosis/management of suspected new patients with IBD; (2) facilities available; (3) ongoing management of IBD; and (4) direct impact of COVID-19 on patients with IBD. Results: All centres contributed. Two centres retained routine endoscopy, with three unable to perform even urgent IBD endoscopy. 122 patients were diagnosed with IBD, and 53.3% (n=65) were presumed diagnoses and had not undergone endoscopy with histological confirmation. The most common induction was exclusive enteral nutrition (44.6%). No patients with a presumed rather than confirmed diagnosis were started on anti-tumour necrosis factor (TNF) therapy. Most IBD follow-up appointments were able to occur using phone/webcam or face to face. No biologics/immunomodulators were stopped. All centres were able to continue IBD surgery if required, with 14 procedures occurring across seven centres. Conclusions: Diagnostic IBD practice has been hugely impacted by COVID-19, with >50% of new diagnoses not having endoscopy. To date, therapy and review of known paediatric patients with IBD has continued. Planning and resourcing for recovery is crucial to minimise continued secondary morbidity.
AB - Background: COVID-19 has impacted on healthcare provision. Anecdotally, investigations for children with inflammatory bowel disease (IBD) have been restricted, resulting in diagnosis with no histological confirmation and potential secondary morbidity. In this study, we detail practice across the UK to assess impact on services and document the impact of the pandemic. Methods: For the month of April 2020, 20 tertiary paediatric IBD centres were invited to contribute data detailing: (1) diagnosis/management of suspected new patients with IBD; (2) facilities available; (3) ongoing management of IBD; and (4) direct impact of COVID-19 on patients with IBD. Results: All centres contributed. Two centres retained routine endoscopy, with three unable to perform even urgent IBD endoscopy. 122 patients were diagnosed with IBD, and 53.3% (n=65) were presumed diagnoses and had not undergone endoscopy with histological confirmation. The most common induction was exclusive enteral nutrition (44.6%). No patients with a presumed rather than confirmed diagnosis were started on anti-tumour necrosis factor (TNF) therapy. Most IBD follow-up appointments were able to occur using phone/webcam or face to face. No biologics/immunomodulators were stopped. All centres were able to continue IBD surgery if required, with 14 procedures occurring across seven centres. Conclusions: Diagnostic IBD practice has been hugely impacted by COVID-19, with >50% of new diagnoses not having endoscopy. To date, therapy and review of known paediatric patients with IBD has continued. Planning and resourcing for recovery is crucial to minimise continued secondary morbidity.
KW - Gastroenterology
KW - Health services research
UR - http://www.scopus.com/inward/record.url?scp=85094865163&partnerID=8YFLogxK
U2 - 10.1136/archdischild-2020-319751
DO - 10.1136/archdischild-2020-319751
M3 - Article
C2 - 32732316
AN - SCOPUS:85094865163
SN - 0003-9888
VL - 105
SP - 1186
EP - 1191
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
IS - 12
ER -