Epidemiologic Assessment of Pediatric Inflammatory Bowel Disease Presentation in NYC During COVID-19

Abstract

Inflammatory bowel disease (IBD) pathogenesis is thought to be induced by a mix of genetic susceptibility, microbial populations, and immune triggers such as infections. Severe acute respiratory syndrome coronavirus 2 (SARS-nCoV2) may have increased capacity to generate autoimmune disease as evidenced by known spikes in diseases such as type 1 diabetes mellitus. Public health interventions like masking and closures additionally created remarkable drops in typical viral infections, with remarkable shifts in influenza-like illness reporting in 2020. This study aims to evaluate the impact of SARS-nCoV2 and associated interventions on pediatric IBD presentation in New York City using records of new diagnoses at a consortium of 4 institutions between 2016 and June 2022. We fit time series model (autoregressive integrated moving average model) to monthly and quarterly number of cases of each disease for January 2016–March 2020 and forecast the period between April 2020 and June 2022. We note no decrease in ulcerative colitis (UC) or Crohn disease (CD) in the aftermath of historic low levels of overall viral illness, and statistically significant increases in CD diagnoses and elevation in UC diagnoses creating a trend suggesting overall increase in IBD diagnoses exceeding the baseline rate of increase. These data suggest a possible linkage between SARS-nCoV2 infection rates and subsequent pediatric IBD presentation.

A Case Series of New-Onset Ulcerative Colitis Following Recent Diagnosis of COVID-19

“…There are only a few reported cases of adult patients who developed IBD following COVID-19 and 2 case reports of pediatric patients who developed new-onset Crohn disease, including 1 with concurrent multi-inflammatory syndrome in children ( 7 ). Finally, this case series confirms epidemiological assessments of IBD in New York City that have suggested a link between COVID-19 and UC ( 8 ).…”

Evolving Landscape of Paediatric Inflammatory Bowel Disease: Insights from a Decade-Long Study in North-East Slovenia on Incidence, Management, Diagnostic Delays, and Early Biologic Intervention

“…This increase coincided with the onset of the COVID-19 pandemic. Similar trends were observed in the study from Ashton et al [14] from the south of England and Rosenbaum et al [15] from New York City (NYC), both reporting a rise in incidence at the beginning of the 2020 pandemic. These findings prompt inquiries into the potential association between viral illnesses, particularly SARS-CoV-2, and the pathogenesis of IBD.…”

Coronavirus disease 2019 and gastrointestinal disorders in children

“…A US study with data on 587 pediatric IBD cases showed an increased incidence of pediatric IBD diagnoses during the COVID-19 pandemic compared to the expected number based on historic time trend data. 144 In contrast, the most extensive study of some 4300 IBD patients reported a lower risk of incident IBD following SARS-CoV-2 compared to a propensity-score matched cohort who tested negative for SARS-CoV-2 (RR 0.63; 95% CI: 0.58–0.70). 122 The lower IBD incidence post-COVID remained essentially unchanged when restricted to IBD diagnosed >6 months after testing for COVID-19.…”