The impact of the COVID-19 pandemic on the course of Clostridioides difficile infection in patients with inflammatory bowel disease
, 2, 2
Abstract
Introduction: 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. This study aimed 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).
Material and methods: A retrospective study involved a total of 61 patients and compared the course of
CDI in IBD patients in the 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 in increasing
the CDI incidence. Patients with UC comprised 85.71% of the control group and 67.74% of the treatment
group. The authors 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).
Conclusions: The COVID-19 pandemic contributed to an increase in CDI incidence in IBD patients. The
infections require 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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