Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2023; 11(23): 5462-5467
Published online Aug 16, 2023. doi: 10.12998/wjcc.v11.i23.5462
Progress of ulcerative colitis patients during the COVID-19 pandemic
Toshikuni Suda, Morio Takahashi, Yasumi Katayama, Koichi Soga, Ikuhiro Kobori, Yumi Kusano, Masaya Tamano
Toshikuni Suda, Yasumi Katayama, Koichi Soga, Ikuhiro Kobori, Yumi Kusano, Masaya Tamano, Division of Gastroenterology, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan
Morio Takahashi, Division of Gastroenterology, Morio Clinic, Saitama 343-0808, Japan
Author contributions: Suda T recruited patients and wrote the paper; Takahashi M designed the study and analyzed data; Soga K revised the manuscript; Kobori I and Kusano Y provided clinical advice; and Tamano M and Katayama Y supervised the study.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Dokkyo Medical University Saitama Medical Center (Approval No. 20100).
Informed consent statement: All patients provided informed consent to participate in this study and agreed to publication of the research results.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshikuni Suda, Doctor, MD, PhD, Doctor, Instructor, Staff Physician, Division of Gastroenterology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-Koshigaya, Koshigaya-Shi, Saitama 343-8555, Japan. toshikuni.suda@gmail.com
Received: May 24, 2023
Peer-review started: May 24, 2023
First decision: June 20, 2023
Revised: June 30, 2023
Accepted: July 25, 2023
Article in press: July 25, 2023
Published online: August 16, 2023
Processing time: 83 Days and 23.2 Hours
Abstract
BACKGROUND

We have previously demonstrated that the first wave of the coronavirus disease 2019 (COVID-19) pandemic caused exacerbations in ulcerative colitis (UC) patients, probably through psychological and physical stress. However, successive waves of the COVID-19 pandemic continuously followed the first. The effects of this chronic stress on the disease condition in UC patients are of interest.

AIM

To clarify the effect of chronic stress from COVID-19 on disease condition in patients aggravated after the first wave.

METHODS

Our previous study investigated 289 consecutive UC outpatients treated in one center during March and April 2020, the period of the first wave of the COVID-19 pandemic. In this study, an identical group of 289 UC patients was evaluated using UC-disease activity index (UC-DAI), endoscopic mucosal appearance score, and Matts pathological grade scoring.

RESULTS

Of the 289 UC patients included in the study in 2020, 10 patients dropped out as of 2021 and another 11 patients dropped out as of 2022, making three groups for 2020, 2021 and 2022. No significant differences in characteristics were found among the three groups. UC-DAI scores had aggravated during the period of the first wave of the COVID-19 pandemic, but significantly recovered in 2021 and remained stable in 2022. Matts grade scores significantly recovered in 2021 from those in 2020 and remained stable in 2022.

CONCLUSION

Disease activity of UC patients recovered in 2021 and remained stable in 2022, aggravated by the stress of the first wave of COVID-19 in 2020 despite persistence of the pandemic.

Keywords: Ulcerative colitis; COVID-19; Exacerbation; Stress; Ulcerative colitis disease activity index; Matts grade

Core Tip: Previously, we demonstrated that the first wave of coronavirus disease 2019 (COVID-19) pandemic caused exacerbation in ulcerative colitis (UC) patients. Impact of the successive waves of the pandemic is of interest. We adopted the identical group of patients who were included in our previous study indicating the impact of the first wave in 2020. Disease activity of UC patients, aggravated by the stress of the first wave of COVID-19 in 2020, recovered significantly in 2021 and remained stable in 2022, despite persistence of the pandemic.