Published online May 28, 2024. doi: 10.3748/wjg.v30.i20.2677
Revised: January 10, 2024
Accepted: February 22, 2024
Published online: May 28, 2024
Processing time: 188 Days and 20.4 Hours
The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare in the United States.
To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease (IBD) decedents.
We performed a register-based study using data from the National Vital Statistics System, which reports death data from over 99% of the United States population, from January 1, 2006 through December 31, 2021. IBD-related deaths among adults 25 years and older were stratified by age, sex, race/ethnicity, place of death, and primary cause of death. Predicted and actual age-standardized mortality rates (ASMRs) per 100000 persons were compared.
49782 IBD-related deaths occurred during the study period. Non-COVID-19-related deaths increased by 13.14% in 2020 and 18.12% in 2021 [2020 ASMR: 1.55 actual vs 1.37 predicted, 95% confidence interval (CI): 1.26-1.49; 2021 ASMR: 1.63 actual vs 1.38 predicted, 95%CI: 1.26-1.49]. In 2020, non-COVID-19-related mortality increased by 17.65% in ulcerative colitis (UC) patients between the ages of 25 and 65 and 36.36% in non-Hispanic black (NHB) Crohn’s disease (CD) patients. During the pandemic, deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.
IBD patients suffered excess non-COVID-19-related death during the pandemic. Excess death was associated with younger age among UC patients, and with NHB race among CD patients. Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.
Core Tip: The coronavirus disease 2019 (COVID-19) pandemic disrupted healthcare in the United States. Excess non-COVID-19-related mortality during the COVID-19 pandemic has been reported in several chronic conditions, including cardiovascular disease, alcohol use disorder, diabetes mellitus, and cirrhosis. We found that inflammatory bowel disease patients also experienced excess non-COVID-19-related mortality during the COVID-19 pandemic. Young ulcerative colitis patients and non-Hispanic black patients with Crohn’s disease were particularly affected, with 17.65% and 36.36% increase in non-COVID-19-related death in 2020, respectively.