The impact of the COVID-19 pandemic on the course of Clostridioides difficile infection in patients with inflammatory bowel disease.
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Abstract
Background: Patients with inflammatory bowel disease (IBD) are at high risk of Clostridioides difficile infection (CDI). The Coronavirus disease 2019 (COVID-19) pandemic was a special time, that had an impact on the course of many diseases. We aimed in this study to determine the influence of the COVID-19 pandemic on the course of CDI in patients with ulcerative colitis (UC) and Crohn's disease (CD). Methods: A retrospective study involved a total of 61 patients. We compared the course of CDI in IBD patients in pre-pandemic period (2015-2020) and after the second wave of COVID-19 (2022-2023). The analysis included demographic, clinical, laboratory data and CDI risk factors. The course of CDI was divided into benign, severe and severe-complicated. Results: In five years before the pandemic in IBD patients, there were 35 cases of CDI, whereas in 15 months after the first COVID-19 wave, there were 31 CDI. In the quartile comparison, the CDI incidence increased in the pandemic period (p=0.021).The antibiotherapy wasn't a significant factor increasing the CDI incidence. Patients with UC comprised 85.71% of the control group and 67.74% of the treatment group. We obtained a statistically significant higher rate of using an increased vancomycin dose (p=0.010) and recurrences of CDI (p=0.045) in the totality of IBD patients and only with ulcerative colitis (p=0.001), (p=0.020). Conclusion: The COVID-19 pandemic contributed to an increase in CDI incidence in IBD patients. The infections required treatment intensification and are characterized by increased recurrence, especially in patients with UC.
Keywords: Clostridioides difficile infectionCOVID-19 pandemicinflammatory bowel diseaseCrohn’s diseaseulcerative colitis
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