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Impact of COVID-19 on Venous Thromboembolism in Inflammatory Bowel Disease Hospitalizations: A Propensity-Matched
Mihir Prakash Shah1, Dushyant Singh Dahiya2, Pius Ojemolon3
1Department of Internal Medicine University of Oklahoma Oklahoma City Oklahoma USA.
Insights
Patients with Inflammatory Bowel Disease (IBD) and COVID-19 face increased risks of venous thromboembolism (VTE). Complicated COVID-19 in IBD patients significantly elevates VTE and mortality odds, highlighting a critical health concern.
Area of Science:
- Gastroenterology and Hepatology
- Infectious Diseases
- Cardiology and Vascular Medicine
Background:
- Inflammatory Bowel Disease (IBD) patients have a higher risk of venous thromboembolism (VTE).
- Coronavirus disease 2019 (COVID-19) is linked to increased thrombosis risk.
- The combined impact of COVID-19 and IBD on VTE risk is not fully understood.
Purpose of the Study:
- To evaluate the effect of COVID-19 on VTE development in patients with Inflammatory Bowel Disease.
- To compare VTE risk, mortality, and healthcare burden among IBD patients with and without COVID-19.
Main Methods:
- Retrospective analysis of the National Inpatient Sample (NIS) database for 2020-21.
- Inclusion of adult patients with IBD, categorized into three groups: no COVID-19, uncomplicated COVID-19, and complicated COVID-19.
- Comparison of hospitalization characteristics, in-hospital mortality, VTE odds, healthcare utilization, and secondary outcomes.
Main Results:
- IBD patients with complicated COVID-19 showed significantly higher odds of VTE (OR 5.60) and mortality (OR 29.13) compared to those without COVID-19.
- IBD patients with uncomplicated COVID-19 also had increased odds of VTE (OR 1.81) but no significant difference in mortality or length of stay.
- Complicated COVID-19 in IBD patients was associated with higher healthcare resource utilization and worse secondary outcomes like acute kidney injury and pancytopenia.
Conclusions:
- Both complicated and uncomplicated COVID-19 increase VTE risk in IBD patients.
- Complicated COVID-19 in IBD patients is associated with a substantially higher risk of mortality.
- These findings underscore the heightened thrombotic and mortality risks for IBD patients co-infected with SARS-CoV-2.
Background And Aim:
Patients diagnosed with Inflammatory bowel disease (IBD) face a notably higher risk of venous thromboembolism (VTE), leading to significant health challenges. Similarly, coronavirus disease 2019 (COVID-19) is associated with an increased susceptibility to thrombosis. We aimed to assess the impact of COVID-19 on the risk of developing VTE in patients with an underlying diagnosis of IBD.
Methods:
We retrospectively analyzed the National Inpatient Sample (NIS) 2020-21 to identify adult patients with IBD admitted with or without a principal diagnosis of COVID-19. We divided these patients into three groups (without COVID-19, with uncomplicated COVID-19, and with complicated COVID-19). Hospitalization characteristics, in-hospital mortality, odds of VTE, healthcare burden, and complications were compared.
Results:
IBD patients with complicated COVID-19 infection had significantly higher odds of VTE (OR 5.60, 95% C.I. 3.63-8.65, p 0.001), an increase in odds of mortality (OR 29.13, 95% C.I. 22.59-37.57, p 0.001), higher healthcare resource utilization (including length of stay and total hospitalization charges), and worse secondary outcomes (like acute kidney injury and pancytopenia), compared to IBD patients without COVID-19. IBD patients with uncomplicated COVID-19 also had higher odds of VTE (OR 1.81, 95% C.I. 1.39-2.36, p 0.001) than those without COVID-19; however, there was no difference in mortality or length of stay between these two groups, and those with uncomplicated COVID-19 had lower average total hospitalization charges.
Conclusion:
Patients with both complicated and uncomplicated COVID-19 were associated with higher odds of VTE compared to those without COVID-19. Patients with complicated COVID-19, in addition, also had higher odds of mortality.
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