COVID‐19 infection in patients with intestinal failure: UK experience

Abstract

Background: The direct effect of the COVID-19 pandemic on patients with intestinal failure (IF) has not been described. Methods: We conducted a nationwide study of U.K. IF centres to evaluate the infection rates, presentations and outcomes in patients with types 2 and 3 IF. Results: A total of 45 patients with IF contracted COVID-19 between March and August 2020; this included 26 of 2191 (1.2%) Home Parenteral Nutrition (HPN)-dependent adults and 19 of 298 (6.4%) adults hospitalized with type 2 IF. The proportion of patients receiving nursing care for HPN administration was higher in those with community-acquired COVID-19 (66.7%) than the proportion in the entire HPN cohort (26.1%; p<0.01). Two HPN-dependent and 1 hospitalised patient with type 2 IF died as a direct consequence of the virus (6.7% of 45 patients with types 2 or 3 infected). Conclusion: This is the first study to describe the outcomes of COVID-19 in a large cohort of patients of requiring long term PN. Methods to reduce hospital and community nosocomial spread would likely be beneficial. Clinical relevancy statement 1.2% of 2191 HPN-dependent adults and 6.4% of 298 hospitalized adults with acute severe IF contracted COVID-19 during the first wave of the pandemic in the U.K. 6.7% of adults with types 2 or 3 IF infected with COVID-19 during the study period died as a direct result of viral infection. Methods to reduce hospital and community nosocomial spread would be beneficial.

Severe acute respiratory syndrome coronavirus 2 antibody prevalence in adult patients with short bowel syndrome—A German multicenter cross‐sectional study

“…We here present one of the first antibody prevalence study against SARS‐CoV‐2 N antigen in patients with SBS and show a seroprevalence of 7.6% over the course of the year 2021. Despite previous studies showing an association with the rate of community‐acquired COVID‐19 and frequency of contact with nursing staff in patients with intestinal failure in the United Kingdom, our seroprevalence was within the German national average, which was 4.1%–11.6% measured in antibodies against the spike (S) antigen for the first half of 2021 14,15 . More recent data from July 2021 to October 2021 suggest a seroprevalence of up to 7.9% (KoCo19 Study) 16,17 …”

The Effect of the COVID-19 Pandemic in Intestinal Rehabilitation and Transplant Patients: Initial Results of the Intestinal Rehabilitation and Transplant Association’s International Survey

“…Three patients, all adults, died as a consequence of the disease. 10 By conducting an international survey, the same author was able to obtain information from 78 of the 122 (57%) home PN centers, reporting 37 positive patients and 2 deaths from 18 centers. 11 Our survey contributes by providing an incidence report for IF patients, which is lower than cirrhotic, dialysis, and IT patients.…”

“…During the pandemic, multidisciplinary IF teams had to adapt their clinical approaches to protect this vulnerable group of patients by reducing the number of visits, implementing telemedicine, and carefully evaluating the impact of increasing home self-care, reducing the number of visits of nurses or PN suppliers, and by modifying the posttransplant follow-up protocols, including surveillance biopsies. 10 , 11 …”

“…Therefore, both groups are considered highly susceptible to COVID-19. [10][11][12] During the pandemic, multidisciplinary IF teams had to adapt their clinical approaches to protect this vulnerable group of patients by reducing the number of visits, implementing telemedicine, and carefully evaluating the impact of increasing home self-care, reducing the number of visits of nurses or PN suppliers, and by modifying the posttransplant follow-up protocols, including surveillance biopsies. 10,11 Among all the published articles and specifically when looking into surveys that pertain to the transplant community, no specific data are available to understand the impact of the disease on the IT population.…”

Hypophosphatemia at Admission is Associated with Increased Mortality in COVID-19 Patients

“…39 The widespread intestinal dysfunction and acute kidney injury seen in COVID-19 patients may be another risk factor for hypophosphatemia. [40][41][42][43] In addition, common digestive symptoms, such as diarrhea and vomiting, will also result in high levels of nutrient wastage. Thirdly, hyperventilation is another possible risk factor for hypophosphatemia.…”