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Progress of ulcerative colitis patients during the COVID-19 pandemic
Toshikuni Suda1, Morio Takahashi2, Yasumi Katayama3
1Division of Gastroenterology, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan. toshikuni.suda@gmail.com.
Insights
Ulcerative colitis (UC) patients
Area of Science:
- Gastroenterology and Immunology
- Infectious Diseases and Public Health
Background:
- The initial COVID-19 wave exacerbated ulcerative colitis (UC) likely due to stress.
- Subsequent pandemic waves introduced chronic stress, necessitating investigation into long-term effects on UC patients.
Purpose of the Study:
- To assess the impact of sustained COVID-19 pandemic stress on UC disease activity and patient outcomes.
- To evaluate UC patient condition beyond the initial pandemic wave.
Main Methods:
- A cohort of 289 ulcerative colitis outpatients from a 2020 study was re-evaluated in 2021 and 2022.
- Disease activity was measured using the UC-disease activity index (UC-DAI), endoscopic mucosal appearance, and Matts pathological grade.
Main Results:
- UC-DAI scores, initially aggravated during the first COVID-19 wave, significantly improved by 2021 and remained stable through 2022.
- Matts grade scores showed significant recovery in 2021 and stability in 2022, indicating improved mucosal healing.
- Patient characteristics remained consistent across the study years, supporting the validity of the observed changes.
Conclusions:
- Despite ongoing pandemic stress, ulcerative colitis disease activity and endoscopic findings improved significantly in 2021 and were sustained in 2022.
- These findings suggest that UC patients can achieve disease remission and stability even amidst prolonged public health crises.
Background:
We have previously demonstrated that the first wave of the coronavirus disease 2019 (COVID-19) pandemic caused exacerbations in ulcerative colitis (UC) patients, probably through psychological and physical stress. However, successive waves of the COVID-19 pandemic continuously followed the first. The effects of this chronic stress on the disease condition in UC patients are of interest.
Aim:
To clarify the effect of chronic stress from COVID-19 on disease condition in patients aggravated after the first wave.
Methods:
Our previous study investigated 289 consecutive UC outpatients treated in one center during March and April 2020, the period of the first wave of the COVID-19 pandemic. In this study, an identical group of 289 UC patients was evaluated using UC-disease activity index (UC-DAI), endoscopic mucosal appearance score, and Matts pathological grade scoring.
Results:
Of the 289 UC patients included in the study in 2020, 10 patients dropped out as of 2021 and another 11 patients dropped out as of 2022, making three groups for 2020, 2021 and 2022. No significant differences in characteristics were found among the three groups. UC-DAI scores had aggravated during the period of the first wave of the COVID-19 pandemic, but significantly recovered in 2021 and remained stable in 2022. Matts grade scores significantly recovered in 2021 from those in 2020 and remained stable in 2022.
Conclusion:
Disease activity of UC patients recovered in 2021 and remained stable in 2022, aggravated by the stress of the first wave of COVID-19 in 2020 despite persistence of the pandemic.
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