1. Impact of COVID-19 on diagnosis and management of paediatric inflammatory bowel disease during lockdown: a UK nationwide study
- Author
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Jenny Epstein, Maureen Lawson, David Devadason, Franco Torrente, Richard Hansen, Veena Zamvar, Robert Mark Beattie, Lucy Howarth, James J. Ashton, Ahmed Kadir, Rafeeq Muhammed, Jochen Kammermeier, Protima Deb, Priya Narula, Richard K Russell, Elizabeth Renji, Fevronia Kiparissi, Christine Spray, Ben Hope, Hemant S. Bhavsar, and Thankam Paul
- Subjects
Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Adolescent ,Child Health Services ,Inflammatory bowel disease ,Ambulatory Care Facilities ,Endoscopy, Gastrointestinal ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Enteral Nutrition ,030225 pediatrics ,Pandemic ,Health care ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,Medical diagnosis ,Intensive care medicine ,Child ,Health Services Needs and Demand ,medicine.diagnostic_test ,business.industry ,SARS-CoV-2 ,Health services research ,COVID-19 ,medicine.disease ,Inflammatory Bowel Diseases ,United Kingdom ,Endoscopy ,Parenteral nutrition ,Health Care Surveys ,Pediatrics, Perinatology and Child Health ,Communicable Disease Control ,030211 gastroenterology & hepatology ,Female ,Tumor Necrosis Factor Inhibitors ,business - Abstract
BackgroundCOVID-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.MethodsFor 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.ResultsAll 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.ConclusionsDiagnostic 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.
- Published
- 2020
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