Researchers evaluate COVID-19’s impact on IBD patients, GI fellowship training in two separate studies

COVID-19 brought with it numerous questions and concerns for people with gastroenterological conditions and the providers who care for them. Clinical researchers at118金宝搏抽水Penn State Health Milton S. Hershey Medical Centerwere involved in two multi-institutional collaborative studies, one to evaluate the impact of coronavirus disease on clinical course of inflammatory bowel disease (IBD) including treatment, and the other to determine the impact of COVID-19 on gastroenterology (GI) and hepatology fellows’ training in the United States.

Risk for severe COVID-19 in IBD patients

As part of their treatment regimen for IBD, patients often use medications including biologics, small molecules and steroids that suppress the immune system. While a worldwide registry—Surveillance Epidemiology of Coronavirus Under Research Exclusion—has reported the clinical course of COVID-19 among IBD patients and the factors associated with severe COVID-19. there is still an evolving understanding and limited data comparing the clinical characteristics and outcomes among IBD patients with COVID-19 compared to patients without IBD in the U.S.

“So, we put together a multi-institutional group of people to review large data sets to help give us a better understanding about the relationship between COVID-19 and IBD,” saidDr. Kofi Clarke, chief of the Division of Gastroenterology and Hepatology at the Milton S. Hershey Medical Center.

Using a federated health research network data set (TriNetX), the collaborators performed a search and analysis of electronic health records and identified 232 IBD patients diagnosed with COVID-19 in the U.S. between Jan. 20 and May 26, 2020. They then compared various clinical data points in their electronic health records with those of non-IBD patients diagnosed with COVID-19 during the same period.

在不调整的分析中，IBD和非IBD患者之间严重Covid-19的风险没有差异。经过倾向分数匹配后，两组与严重Covid-19的风险相似。克拉克说，治疗。

因为结果表明没有增加风险，所以提供者应该鼓励IBD患者在大流行期间留在免疫抑制疗法上。测试Covid-19阳性的患者需要由Covid-19症状的临床提供者进行评估，因为潜在的IBD的持续治疗和严重程度和活动的日期。通过该完整的数据，提供商可以提供关于其药物给药的建议。
Clarke’s research collaborators included Shailendra Singh, Ahmad Khan and Monica Chowdhry with West Virginia University Health Sciences Division; Mohammad Bilal with Beth Israel Deaconess Medical Center; and Gursimran S. Kochhar with Allegheny Health Network.

评估Covid-19对美国的影响和肝脏研究员

在Covid-19的第一个浪潮中，在2020年3月，专业的社会要求医院取消和重新安排选修程序和内窥镜。停工也影响了美国，其中大量毕业于6月20日的综合症，也影响了GI和肝脏研究员的教育。

To learn more about fellows’ perceptions, changes in clinical duties and education during the pandemic, researchers distributed a questionnaire nationwide. A total of 177 GI fellows responded. The results showed that COVID-19 impacted all aspects of U.S. GI fellowship training—endoscopy, outpatient clinics, inpatient consults and educational activities. Specifically:

• 在大流行期间，29.4％的研究员重新部署到非GI服务。
• 72.4％报告了某种类型的内窥镜参与限制，但只有大约三分之一认为这种限制是有保证的, and the majority were concerned about the pandemic’s impact on endoscopic competency.
• 72.5% reported their programs provided increased wellness resources.
• 17.6%的受访者children reported no support with child care.²

The results reflected GI trainees concerns about having enough skills to feel confident on graduation, their need for more resources to handle COVID-19-related stressors, and a desire to be consulted prior to their professional groups making major decisions such as surgery stoppages.

“One of the biggest takeaways is the importance of faculty members asking fellows, ‘How are you feeling and how can we support you?’” Clarke said. “We must recognize fellows are also people with real-life concerns.”

Clarke’s research collaborators included Bilal; Sergio A. Sanchez-Luna from Allegheny Health Network; Shannon Dalessio and Jennifer L. Maranki with宾夕法尼亚州立医学院; and Shazia Mehmood Siddique with the University of Pennsylvania Perelman School of Medicine.

参考

1. Singh S, Khan A, Chowdhry M, Bilal M, Kochhar G, Clarke K. Risk of severe coronavirus disease 2019 in patients with inflammatory bowel disease in the United States: A multicenter research network study.胃肠病学2020;159:1575-1578. doi:10.1053 / J.Gastro.2020.06.003
2. Clarke K, Bilal M, Sanchez-Luna S.A. et al. Impact of COVID-19 pandemic on training: Global perceptions of gastroenterology and hepatology fellows in the USA.挖掘sci。2020 Oct 19;1-5. doi:https://doi.org/10.1007/S10620-020-06655.Y.Y.