Impact of COVID-19 on Venous Thromboembolism in Inflammatory Bowel Disease Hospitalizations: A Propensity-Matched Analysis
Abstract
BACKGROUND AND AIM: Patients diagnosed with Inflammatory bowel disease (IBD) face a notably higher risk of venous thromboembolism (VTE), leading to significant health challenges. Similarly, coronavirus disease 2019 (COVID-19) is associated with an increased susceptibility to thrombosis. We aimed to assess the impact of COVID-19 on the risk of developing VTE in patients with an underlying diagnosis of IBD. METHODS: We retrospectively analyzed the National Inpatient Sample (NIS) 2020-21 to identify adult patients with IBD admitted with or without a principal diagnosis of COVID-19. We divided these patients into three groups (without COVID-19, with uncomplicated COVID-19, and with complicated COVID-19). Hospitalization characteristics, in-hospital mortality, odds of VTE, healthcare burden, and complications were compared. RESULTS: IBD patients with complicated COVID-19 infection had significantly higher odds of VTE (OR 5.60, 95% C.I. 3.63-8.65, p 0.001), an increase in odds of mortality (OR 29.13, 95% C.I. 22.59-37.57, p 0.001), higher healthcare resource utilization (including length of stay and total hospitalization charges), and worse secondary outcomes (like acute kidney injury and pancytopenia), compared to IBD patients without COVID-19. IBD patients with uncomplicated COVID-19 also had higher odds of VTE (OR 1.81, 95% C.I. 1.39-2.36, p 0.001) than those without COVID-19; however, there was no difference in mortality or length of stay between these two groups, and those with uncomplicated COVID-19 had lower average total hospitalization charges. CONCLUSION: Patients with both complicated and uncomplicated COVID-19 were associated with higher odds of VTE compared to those without COVID-19. Patients with complicated COVID-19, in addition, also had higher odds of mortality.