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COVID-19 大流行对小儿炎症性肠病管理的影响:代表 SIGENP IBD 小组的意大利多中心研究。

Impact of COVID-19 pandemic on the management of paediatric inflammatory bowel disease: An Italian multicentre study on behalf of the SIGENP IBD Group.

机构信息

Pediatric Gastroenterology and Endoscopy Unit, Institute 'Giannina Gaslini', Genoa, Italy.

Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy.

出版信息

Dig Liver Dis. 2021 Mar;53(3):283-288. doi: 10.1016/j.dld.2020.12.011. Epub 2020 Dec 26.

Abstract

BACKGROUND

IBD management has been significantly affected during the COVID-19 lockdown with potential clinical issues.

AIMS

The aim of this study was to analyse the impact of COVID-19 pandemic on the Italian paediatric IBD cohort.

METHODS

This was a multicentre, retrospective, cohort investigation including 21 different Italian IBD referral centres. An electronic data collection was performed among the participating centres including: clinical characteristics of IBD patients, number of COVID-19 cases and clinical outcomes, disease management during the lockdown and the previous 9 weeks.

RESULTS

2291 children affected by IBD were enrolled. We experienced a significant reduction of the hospital admissions [604/2291 (26.3%) vs 1281/2291 (55.9%); p < 0.001]. More specifically, we observed a reduction of hospitalizations for new diagnosis (from n = 44 to n = 27) and endoscopic re-evaluations (from n = 46 to n = 8). Hospitalization for relapses and surgical procedures remained substantially unchanged. Biologic infusions did not significantly vary [393/2291 (17.1%) vs 368/2291 (16%); p = 0.3]. Telemedicine services for children with IBD were activated in 52.3% of the centres. In 42/2291(1.8%) children immunosuppressive therapies were adapted due to the concurrent COVID-19 pandemic.

CONCLUSION

Due to the several limitations of the lockdown, cares for children with IBD have been kept to minimal standards, giving priorities to the urgencies and to biologics' infusions and implementing telemedicine services.

摘要

背景

COVID-19 封锁期间,IBD 管理受到了重大影响,可能存在临床问题。

目的

本研究旨在分析 COVID-19 大流行对意大利儿科 IBD 患者群体的影响。

方法

这是一项多中心、回顾性队列研究,包括 21 个不同的意大利 IBD 转诊中心。参与中心进行了电子数据采集,包括:IBD 患者的临床特征、COVID-19 病例数量和临床结果、封锁期间和之前 9 周的疾病管理。

结果

共纳入 2291 例 IBD 患儿。我们观察到住院治疗显著减少[604/2291(26.3%)比 1281/2291(55.9%);p<0.001]。更具体地说,我们观察到新诊断住院(从 n=44 例降至 n=27 例)和内镜再评估(从 n=46 例降至 n=8 例)的减少。复发和手术治疗的住院率基本不变。生物制剂输注没有显著变化[393/2291(17.1%)比 368/2291(16%);p=0.3]。52.3%的中心为 IBD 患儿启动了远程医疗服务。由于同时发生 COVID-19 大流行,42/2291(1.8%)名患儿调整了免疫抑制治疗。

结论

由于封锁的多种限制,对 IBD 患儿的护理保持在最低标准,优先考虑紧急情况和生物制剂输注,并实施远程医疗服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc9a/7832380/760a1fba59d9/gr1_lrg.jpg

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