P3620 - Outcomes in Patients Hospitalized for an Inflammatory Bowel Disease Flare and Concomitant COVID-19 Infection

Christian Karime, MD¹, Miguel Salazar, MD², Muhammad B. Hammami, MD², Jana G.. Hashash, MD, MSc, FACG¹, Francis A. Farraye, MD, MSc, MACG^1
1Mayo Clinic, Jacksonville, FL; ²University of California Riverside, Riverside, CA

Introduction: Patients with inflammatory bowel disease (IBD) are at an increased risk of complications during hospitalization for an IBD flare. Associated with systemic inflammation, limited data exists on the impact of COVID-19 infection on patients hospitalized for an IBD flare.

Methods: We performed a retrospective review of the 2020 National Inpatient Sample (NIS) ICD10-CM and PCS codes for patients admitted with a principal diagnosis of IBD flare with or without a secondary diagnosis of COVID-19. Primary outcomes were in-hospital complications. Secondary outcomes were length of stay (LOS) and healthcare utilization. Frequencies and demographics were compared between groups. Multivariate regression analysis adjusting for patient and hospital characteristics was performed.

Results: A total of 87,374 admissions for IBD flare were identified, of which 669 had a secondary diagnosis of COVID-19. Compared to patients without COVID-19, patients admitted for IBD flare and concomitant COVID-19 were more likely to be African American (20.2% vs 13.7%, p=0.04) or Hispanic (17.2% vs 8.5%, p< 0.01) and be from the lower quartile of income (34.4% vs 24.0%, p< 0.01). Adjusting for patient characteristics on multivariate regression, patients admitted for IBD flare and concomitant COVID-19 had higher odds of intestinal and extra-intestinal complications, including; intestinal perforation (aOR 3.0, p< 0.01), exploratory laparotomy (aOR 13.7, p< 0.01), venous thromboembolism (VTE; aOR 2.4, p=0.05), acute respiratory failure (ARF; aOR 6.6, p< 0.01), intubation (aOR 3.8, p< 0.05), and mechanical ventilation > 96 hours (aOR 13.6, p< 0.01). In-hospital mortality was noted to be increased 4.9-fold, with increased adjusted LOS. Strongest predictors of in-hospital mortality at p< 0.01 were ARF (aOR 16.1), intubation (aOR 15.0), ethanol abuse (aOR 7.1), sepsis (aOR 6.3), Charlson comorbidity score >3 (aOR 5.2), clostridioides difficile infection (aOR 4.5), need for blood products (aOR 2.8), and age >65 years (aOR 1.1).

Discussion: Patients hospitalized for an IBD flare and concomitant COVID-19 infection were found to have increased odds of intestinal and extra-intestinal complications, including 2.4-fold increase in VTE and 3-fold increase in intestinal perforation. Additionally, a 4.9-fold increase in hospital mortality was noted, with several predictors identified. Further studies are needed to evaluate trends in mortality and complications from 2021-2022 NIS data when available.


Disclosures:


Christian Karime, MD¹, Miguel Salazar, MD², Muhammad B. Hammami, MD², Jana G.. Hashash, MD, MSc, FACG¹, Francis A. Farraye, MD, MSc, MACG¹. P3620 - Outcomes in Patients Hospitalized for an Inflammatory Bowel Disease Flare and Concomitant COVID-19 Infection, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.