The impact of the COVID-19 pandemic on hospital presentations in adults with gastrointestinal infections at a tertiary centre in Australia.

BACKGROUND

The COVID-19 pandemic resulted in the enactment of substantial public health measures aimed at reducing the transmission of respiratory viruses. The impact of these measures on gastrointestinal (GI) infections remains unexplored.

AIMS

To determine whether there was a change in the number of patients presenting to The Royal Melbourne Hospital with GI infections during the COVID-19 pandemic compared to the year prior.

METHODS

We conducted a retrospective, single-centre case-control study comparing the incidence and characteristics of hospitalisations with GI infections from March to August 2019 and across the same months in 2020, corresponding to periods immediately prior to and during the COVID pandemic.

RESULTS

Of 430 presentations with GI infections across both time periods, there was a 51.9% decrease in hospitalisations with GI infections during the pandemic. Patients admitted during the pandemic were more likely to be admitted to the intensive care unit (0.71% vs 3.4%, P < 0.04) and to be prescribed antibiotics (21.9% vs 36.1%, P < 0.01). Length of stay and mortality were unchanged. There was a decline in the number and proportion of patients with positive faecal cultures in 2020, primarily attributed to a significant reduction in Norovirus cases (28% vs 4%) (odds ratio (OR) = 0.093, P < 0.01). Conversely, the proportion of patients presenting with Clostridioides difficile was higher in 2020 (22% vs 44%) (OR = 2.4, P = 0.01).

CONCLUSION

There was a substantial decrease in hospital admissions with GI infections, particularly Norovirus, during the COVID-19 pandemic. Admissions because of Clostridioides increased. Stringent public health measures reducing interpersonal contact and increased antibiotic prescribing respectively may explain these changes, while an increased reluctance to seek medical care may also have contributed to the sharp overall decrease in hospitalisations.