EMERGENCY ADMISSION PATTERNS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE BEFORE AND DURING THE COVID-19 PANDEMIC: A SINGLE-CENTER RETROSPECTIVE COMPARATIVE STUDY
DOI:
https://doi.org/10.22551/Abstract
During the COVID-19 pandemic, restrictions on outpatient activities, along with logistical and psychological barriers, altered how IBD patients presented clinically. We aimed to assess three key impacts of the pandemic: changes in hospitalization patterns, length of hospital stays, and shifts in the demographic distribution of disease subtypes among hospitalized patients. Materials and methods: A retrospective, single-center study was conducted at the Sf. Spiridon County Emergency Hospital in Iași. The research analyzed 390 unique adult patients hospitalized with IBD, comprising 285 patients from the pre-pandemic period (2018–2019) and 105 from the pandemic period (2020–2021). Demographic and clinical variables were extracted from observation sheets. Comparisons used non-parametric tests, the chi-square and Fisher exact tests, and binary logistic regression, performed in Python (SciPy) at α = 0.05. Results: Emergency admissions rose from 11.6% to 54.3% (OR = 9.07; 95% CI 5.28–15.11; p < 0.001), with comparable increases in ulcerative colitis (OR = 9.69) and Crohn’s disease (OR = 8.17). In logistic regression, the pandemic period was the only independent predictor of emergency admission (adjusted OR = 9.33; 95% CI 5.46–15.95; p < 0.001); age, sex, and disease type were not significant. Median length of stay rose by one day (4 to 5 days; p = 0.010), and anemia was more frequent (28.1% to 39.0%; OR = 1.64; 95% CI 1.03–2.62; p = 0.048). The tripartite analysis revealed that both pandemic subgroups, whether or not patients carried SARS-CoV-2 co-infection, exceeded pre-pandemic emergency rates substantially, but the two subgroups did not differ significantly. Conclusions: Disruption of outpatient care emerged as a systemic factor independent of viral co-infection itself. So, when patients with IBD presented during the pandemic, their demographic profile and disease type distribution remained unchanged, even though presentation patterns shifted significantly. This suggests that protocols dedicated to IBD monitoring should be implemented before future health crises.
References
1. Abdulla M, Mohammed N, AlQamish J, Mosli M. Inflammatory bowel disease and COVID-19 outcomes: a meta-analysis. Sci Rep 2022; 12: 21333.
2. Vitus ES, Mann S, Lees CW, Jess T, Elmahdi R. A systematic review and meta-analysis: adverse inflammatory bowel disease outcomes following acute COVID-19. Gastro Hep Adv 2025; 4: 100581.
3. Costache R, Iacob R, Vadan R, et al. The COVID-19 pandemic impact on inflammatory bowel disease patient’s management in a Romanian tertiary gastroenterology centre. J Crohns Colitis 2021; 15(Suppl 1): S474-S475.
4. Shivaji UN, Majumder S, Rao A, et al. Impact of delayed diagnosis in IBD on clinical outcomes and healthcare delivery. Diagnostics (Basel) 2026; 16: 1043.
5. Derks MEW, Van Lierop LMA, Te Groen M, Kuijpers CCHJ, Nagtegaal ID, Hoentjen F. Long-term impact of the COVID-19 pandemic on inflammatory bowel disease healthcare utilization: a 2-year nationwide update. Inflamm Bowel Dis 2024; 30: 146-149.
6. Malhi G, Minhas G, Chambers J, Mikail M, Khanna R, Wilson A. Increased hospitalization for IBD patients seen in the ER during the COVID-19 pandemic. J Can Assoc Gastroenterol 2022; 5: 271-275.
7. Ergani AC, Aydin VB, Abidin İ, et al. Has the COVID-19 pandemic affected the clinical severity and incidence of inflammatory bowel disease in children? Genel Tip Derg 2026; 36: 1-5.
8. Wu F, Ibarburu GH, Grimes C. The trends and outcomes of inflammatory bowel disease surgery during the COVID-19 pandemic: a retrospective propensity score-matched analysis from a multi-institutional research network. Health Sci Rep 2024; 7: e70107.
9. Agouridis AP, Hadjivasilis A, Vougiouklakis G, et al. Inflammatory bowel disease incidence following COVID-19: a systematic review and meta-analysis. GE Port J Gastroenterol 2026; 33: 387-395.
10. Wu J, Fang Y, Bai B, et al. Clinical characteristics and the risk factors for the exacerbation of symptoms in patients with inflammatory bowel disease during the COVID-19 pandemic. Front Med (Lausanne) 2024; 11: 1404880.
11. Gavrilescu O, Prelipcean CC, Dranga M, Popa IV, Mihai C. Impact of COVID-19 pandemic on the quality of life of IBD patients. Medicina (Kaunas) 2022; 58: 562.
12. Nass BYS, Dibbets P, Markus CR. Impact of the COVID-19 pandemic on inflammatory bowel disease: the role of emotional stress and social isolation. Stress Health 2022; 38: 222-233.
13. Sarb OF, Sarb AD, Leucuta D, Brisc C, Tanțău AI. Predictors of stress, anxiety, depression and quality of life in patients diagnosed with chronic inflammatory bowel disease in Romania: a cross-section observational case-report study. J Clin Med 2026; 15: 1996.
14. Umar N, Harvey P, Adderley NJ, Haroon S, Trudgill N. The time to inflammatory bowel disease diagnosis for patients presenting with abdominal symptoms in primary care and its association with emergency hospital admissions and surgery: a retrospective cohort study. Inflamm Bowel Dis 2025; 31: 140-150.
15. Popa IV, Diculescu M, Mihai C, Cijevschi-Prelipcean C, Burlacu A. COVID-19 and inflammatory bowel diseases: risk assessment, shared molecular pathways, and therapeutic challenges. Gastroenterol Res Pract 2020; 2020: 1918035.
16. Bezzio C, Saibeni S, Variola A, et al. Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study. Gut 2020; 69: 1213-1217.
17. Allocca M, Fiorino G, Zallot C, et al. Incidence and patterns of COVID-19 among inflammatory bowel disease patients from the Nancy and Milan cohorts. Clin Gastroenterol Hepatol 2020; 18: 2134-2135.
18. Stein J, Dignass AU. Management of iron deficiency anemia in inflammatory bowel disease - a practical approach. Ann Gastroenterol 2013; 26: 104-113.
19. Bergamaschi G, Di Sabatino A, Albertini R, et al. Prevalence and pathogenesis of anemia in inflammatory bowel disease. Influence of anti-tumor necrosis factor-α treatment. Haematologica 2010; 95: 199-205.
20. Pînzariu AC, Leonte SM, Trofin AG, et al. Gut microbiota and short-chain fatty acids: key factors in pediatric obesity and therapeutic targets. Int J Mol Sci 2025; 26: 11503.
21. Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet 2017; 390: 2769-2778.
22. Stoian AP, Mitrofan G, Colceag F, et al. Oxidative stress in diabetes: a model of complex thinking applied in medicine. Rev Chim (Bucharest) 2018; 69: 2515-2519.
23. Padurariu M, Prepelita R, Ciobica A, et al. Concept of suicide: neurophysiological/genetic theories and possible oxytocin relevance. Neurophysiology 2016; 48: 312-321.
24. Timofte D, Toarba C, Hogas S, et al. The relevance of oxidative stress status in type 2 diabetes and the chronic consumption of alcohol. Rom Biotechnol Lett 2016; 21: 11247.
25. Molodecky NA, Soon IS, Rabi DM, et al. Increasing incidence and prevalence of the inflamma-tory bowel diseases with time, based on systematic review. Gastroenterology 2012; 142: 46-54.
Additional Files
Published
Issue
Section
License
Copyright (c) 2026 The Medical-Surgical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
COPYRIGHT
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
_____________________________________________________________________________________
_____________________________________________________________________________________
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
- ______________________________/_________________________
- ______________________________/_________________________
- ______________________________/_________________________
N.B. All the authors must sign this form
