P4337 - Clinical Outcomes of COVID-19 in Patients With Inflammatory Bowel Disease: Latest Insights From the National Inpatient Sample

Muhammad Jahanzaib Khan, MD¹, Mohamad Sharbatji, MD², Hameed Ullah, MD³, Hasan S. Raza, MD⁴, Saeed Ali, MD⁵, Ramona Rajapakse, MD^6
1Mather Hospital, Northwell Health, New York, NY; ²AdventHealth Medical Group, AdventHealth, Orlando, FL; ³Saint Luke's Hospital, St. Louis, MO; ⁴University of Illinois, Chicago, IL; ⁵AdventHealth, Orlando, FL; ⁶Northwell Health, Port Jefferson, NY

Introduction: Inflammatory bowel disease (IBD) patients are speculated to have increased COVID-19 complications due to immune dysfunction and immunomodulatory therapies, but the impact remains unclear. Existing studies show mixed results on the severity of COVID-19 in IBD patients. This study compares the clinical outcomes of COVID-19 patients with and without IBD using the latest National Inpatient Sample (NIS) data.

Methods: We conducted a retrospective analysis using the NIS database (2020-2021), sampling 2,573,077 patients hospitalized with a principal diagnosis of COVID-19 using ICD-10 codes. Patients with IBD were identified using ICD-10 codes for both Ulcerative Colitis (UC) and Crohn's Disease (CD). Baseline characteristics, including age, gender, Charlson Comorbidity Index (CCI), and race, were analyzed. Key outcomes assessed were all-cause inpatient mortality, resource utilization, development of acute kidney injury (AKI), and the need for ICU admission. Proportions and means were compared using the chi-square test and Student’s t-test, respectively. Univariate analysis was used to generate unadjusted odds ratios (OR), and multivariate linear and logistic regression models were then constructed to calculate adjusted odds ratios (aOR) for continuous and categorical outcomes, respectively.

Results: There were a total of 14,409 (0.56%) patients diagnosed with IBD in the included population. There was a significantly higher proportion of female patients in the IBD group compared to the non-IBD group (53.32% vs. 47.30%, p< 0.01). Baseline characteristics of the patients in the two groups are described in Table 1. Outcomes revealed no significant difference in mortality between IBD (10.82%) and non-IBD (11.27%) patients (aOR 1.05, p=0.44). ICU admission rates were similar (IBD: 10.79%, non-IBD: 10.45%, aOR 1.13, p=0.06). However, AKI was significantly higher in the IBD group (26.14% vs. 24.79%, aOR 1.17, p< 0.01). Mean length of stay (LOS) was marginally longer for IBD patients (7.92 days vs. 7.77 days, coefficient 0.34, p< 0.05).

Discussion: Our study concludes that aside from a higher incidence of AKI, IBD does not significantly worsen clinical outcomes in COVID-19 patients. These results align with previous research, reinforcing the evidence that IBD may not notably increase the risk of adverse outcomes from COVID-19. However, larger, multicenter studies with more comprehensive data are needed to validate our findings and deepen the understanding of IBD's impact on COVID-19 outcomes.


Disclosures:


Muhammad Jahanzaib Khan, MD¹, Mohamad Sharbatji, MD², Hameed Ullah, MD³, Hasan S. Raza, MD⁴, Saeed Ali, MD⁵, Ramona Rajapakse, MD⁶. P4337 - Clinical Outcomes of COVID-19 in Patients With Inflammatory Bowel Disease: Latest Insights From the National Inpatient Sample, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.