Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 16, Number 5, October 2023, pages 262-269

COVID-19 Outcomes in Inflammatory Bowel Disease Hospitalized Patients: A Comprehensive Analysis Using the National Inpatient Sample

**Table 1.** Baseline Characteristics of Patients With COVID-19 With IBD and COVID-19 Without IBD
Baseline characteristics	No IBD (weighted n = 1,044,290)	IBD (weighted n = 5,750)	Total (weighted n = 1,050,040)	P value
IBD: inflammatory bowel disease; PPM: permanent pacemaker; ICD: implantable cardioverter-defibrillator; SE: standard error.
Age (mean (SE)), years	64.74 (0.08)	64.30 (0.47)	64.74 (0.08)	0.333
Gender (%)
Male	52.84	46.63	52.8	< 0.001
Female	47.16	53.57	47.2	< 0.001
Race (%)				< 0.001
White	52.52	76.61	52.66
Black	18.51	11.29	18.47
Hispanics	20.59	8.78	20.53
Others	8.38	3.32	8.35
Comorbidities (%)
Chronic pulmonary disease	23.44	30.52	23.48	< 0.001
Atrial fibrillation	11.55	12.09	11.55	0.578
Diabetes mellitus	40.83	29.3	40.76	< 0.001
Hypertension	67.7	63.13	67.68	0.001
Congestive heart failure	16.76	16.61	16.76	0.889
Obesity	27.39	22.78	27.37	0.001
Peripheral vascular disease	4.53	5.83	4.53	0.039
Renal failure	20.16	18.35	20.15	0.124
Liver disease	4.51	6.52	4.52	0.002
Neurological disorders	14.22	15.65	14.23	0.154
Deficiency anemias	3.42	5.22	3.43	0.001
Hypothyroidism	13.93	17.65	13.95	< 0.001
Valvular disease	3.87	5.04	3.88	0.036
Smoking	26.94	35.65	26.99	< 0.001
Alcohol abuse	1.88	2.52	1.88	0.106
Drug abuse	1.82	2.87	1.83	0.011
Carotid artery disease	0.49	0.26	0.49	0.272
Dyslipidemia	42.36	41.39	42.36	0.511
Ischemic heart disease	22.24	22.96	22.24	0.556
Prior cerebrovascular disease	8.41	6.35	8.4	0.013
Prior PPM or ICD		3.39	3.56	0.768
Hospital location (%)	3.56			0.353
Rural	11.75	10.52	11.74
Urban non-teaching	19.31	18.61	19.3
Urban teaching			68.95
Bed size of the hospital (%)	68.94	70.87		0.299
Small	25.7	24.78	25.7
Medium	28.92	27.48	28.91
Large	45.38	47.74	45.39
Region (%)				< 0.001
Northeast	17.66	20.43	17.68
Midwest	23.25	30.35	23.29
South	41.88	35.04	41.84
West		14.17	17.19
Primary expected payor (%)	17.21			< 0.001
Medicare	52.32	56.97	52.34
Medicaid	11.63	8.28	11.61
Private insurance	27.7	30.66	27.72
Self-pay, no charge, or other			8.33
Elixhauser comorbidity index (%)	8.35	4.09		0.052
0 - 4	68.31	66.17	68.3
5 - 8	29.77	31.04	29.78
≥ 9	1.92	2.78	1.92

Table 1. Baseline Characteristics of Patients With COVID-19 With IBD and COVID-19 Without IBD

Baseline characteristics

No IBD (weighted n = 1,044,290)

IBD (weighted n = 5,750)

Total (weighted n = 1,050,040)

P value

IBD: inflammatory bowel disease; PPM: permanent pacemaker; ICD: implantable cardioverter-defibrillator; SE: standard error.

Age (mean (SE)), years

64.74 (0.08)

64.30 (0.47)

64.74 (0.08)

0.333

Gender (%)

Male

52.84

46.63

52.8

< 0.001

Female

47.16

53.57

47.2

< 0.001

Race (%)

< 0.001

White

52.52

76.61

52.66

Black

18.51

11.29

18.47

Hispanics

20.59

8.78

20.53

Others

8.38

3.32

8.35

Comorbidities (%)

Chronic pulmonary disease

23.44

30.52

23.48

< 0.001

Atrial fibrillation

11.55

12.09

11.55

0.578

Diabetes mellitus

40.83

29.3

40.76

< 0.001

Hypertension

67.7

63.13

67.68

0.001

Congestive heart failure

16.76

16.61

16.76

0.889

Obesity

27.39

22.78

27.37

0.001

Peripheral vascular disease

4.53

5.83

4.53

0.039

Renal failure

20.16

18.35

20.15

0.124

Liver disease

4.51

6.52

4.52

0.002

Neurological disorders

14.22

15.65

14.23

0.154

Deficiency anemias

3.42

5.22

3.43

0.001

Hypothyroidism

13.93

17.65

13.95

< 0.001

Valvular disease

3.87

5.04

3.88

0.036

Smoking

26.94

35.65

26.99

< 0.001

Alcohol abuse

1.88

2.52

1.88

0.106

Drug abuse

1.82

2.87

1.83

0.011

Carotid artery disease

0.49

0.26

0.49

0.272

Dyslipidemia

42.36

41.39

42.36

0.511

Ischemic heart disease

22.24

22.96

22.24

0.556

Prior cerebrovascular disease

8.41

6.35

8.4

0.013

Prior PPM or ICD

3.39

3.56

0.768

Hospital location (%)

3.56

0.353

Rural

11.75

10.52

11.74

Urban non-teaching

19.31

18.61

19.3

Urban teaching

68.95

Bed size of the hospital (%)

68.94

70.87

0.299

Small

25.7

24.78

25.7

Medium

28.92

27.48

28.91

Large

45.38

47.74

45.39

Region (%)

< 0.001

Northeast

17.66

20.43

17.68

Midwest

23.25

30.35

23.29

South

41.88

35.04

41.84

West

14.17

17.19

Primary expected payor (%)

17.21

< 0.001

Medicare

52.32

56.97

52.34

Medicaid

11.63

8.28

11.61

Private insurance

27.7

30.66

27.72

Self-pay, no charge, or other

8.33

Elixhauser comorbidity index (%)

8.35

4.09

0.052

0 - 4

68.31

66.17

68.3

5 - 8

29.77

31.04

29.78

≥ 9

1.92

2.78

1.92

**Table 2.** Clinical Outcomes of Patients With COVID-19 With IBD and COVID-19 Without IBD
Clinical outcomes	No IBD (weighted n = 1,044,290)	IBD (weighted n = 5,750)	Total (weighted n = 1,050,040)	Unadjusted OR	95% CI	Adjusted OR	95% CI
COVID-19 patients with IBD had a higher incidence of acute kidney injury (27.0% vs. 25.3%, aOR: 1.29, 95% CI: 1.1 - 1.5, P = 0.001) than those without IBD. IBD: inflammatory bowel disease; CI: confidence interval; aOR: adjusted odds ratio; LOS: length of stay; SNF: skilled nursing facility; ICF: intermediate care facility; SE: standard error.
Pressor use	1.77	1.3	1.77	0.73	0.45	1.21	0.223	0.80	0.48	1.34	0.401
Invasive mechanical ventilation	9.86	10.26	9.86	1.04	0.86	1.26	0.65	1.18	0.96	1.44	0.109
Cardiogenic shock	0.38	0.35	0.38	0.91	0.34	2.40	0.842	0.97	0.35	2.63	0.946
Disposition to SNF, ICF or other facility	19.77	19.9	19.77	1.01	0.87	1.17	0.914	0.96	0.80	1.15	0.635
Acute kidney injury	25.26	27.04	25.27	1.10	0.96	1.26	0.189	1.29	1.11	1.51	0.001
Acute kidney injury requiring dialysis	1.74	1.65	1.74	0.95	0.61	1.49	0.825	1.09	0.68	1.76	0.719
Gastrostomy	1.27	0.87	1.26	0.68	0.37	1.26	0.225	0.74	0.40	1.37	0.331
Tracheostomy	0.87	0.78	0.87	0.90	0.47	1.73	0.758	0.96	0.49	1.85	0.894
Cardiac arrest	2.78	1.83	2.77	0.65	0.42	1.02	0.062	0.81	0.51	1.28	0.371
In-hospital mortality	11.18	10.35	11.17	0.92	0.76	1.11	0.377	1.00	0.81	1.22	0.973
LOS (mean (SE)), days	7.48 (0.03)	7.7 (0.26)	7.48 (0.03)	0.22	-0.27	0.71	0.383	0.47	-0.02	0.96	0.059
Cost, US$ (mean (SE))	19,085.64 (215.7)	19,160.75 (985.42)	19,086.05 (217.02)	75.11	-1,705.72	1,855.94	0.934	1,272.53	-486.38	3,031.44	0.156

Table 2. Clinical Outcomes of Patients With COVID-19 With IBD and COVID-19 Without IBD

Clinical outcomes

No IBD (weighted n = 1,044,290)

IBD (weighted n = 5,750)

Total (weighted n = 1,050,040)

Unadjusted OR

95% CI

Adjusted OR

95% CI

Lower

Upper

P value

Lower

Upper

P value

COVID-19 patients with IBD had a higher incidence of acute kidney injury (27.0% vs. 25.3%, aOR: 1.29, 95% CI: 1.1 - 1.5, P = 0.001) than those without IBD. IBD: inflammatory bowel disease; CI: confidence interval; aOR: adjusted odds ratio; LOS: length of stay; SNF: skilled nursing facility; ICF: intermediate care facility; SE: standard error.

Pressor use

1.77

1.3

1.77

0.73

0.45

1.21

0.223

0.80

0.48

1.34

0.401

Invasive mechanical ventilation

9.86

10.26

9.86

1.04

0.86

1.26

0.65

1.18

0.96

1.44

0.109

Cardiogenic shock

0.38

0.35

0.38

0.91

0.34

2.40

0.842

0.97

0.35

2.63

0.946

Disposition to SNF, ICF or other facility

19.77

19.9

19.77

1.01

0.87

1.17

0.914

0.96

0.80

1.15

0.635

Acute kidney injury

25.26

27.04

25.27

1.10

0.96

1.26

0.189

1.29

1.11

1.51

0.001

Acute kidney injury requiring dialysis

1.74

1.65

1.74

0.95

0.61

1.49

0.825

1.09

0.68

1.76

0.719

Gastrostomy

1.27

0.87

1.26

0.68

0.37

1.26

0.225

0.74

0.40

1.37

0.331

Tracheostomy

0.87

0.78

0.87

0.90

0.47

1.73

0.758

0.96

0.49

1.85

0.894

Cardiac arrest

2.78

1.83

2.77

0.65

0.42

1.02

0.062

0.81

0.51

1.28

0.371

In-hospital mortality

11.18

10.35

11.17

0.92

0.76

1.11

0.377

1.00

0.81

1.22

0.973

LOS (mean (SE)), days

7.48 (0.03)

7.7 (0.26)

7.48 (0.03)

0.22

-0.27

0.71

0.383

0.47

-0.02

0.96

0.059

Cost, US$ (mean (SE))

19,085.64 (215.7)

19,160.75 (985.42)

19,086.05 (217.02)

75.11

-1,705.72

1,855.94

0.934

1,272.53

-486.38

3,031.44

0.156

**Table 3.** Subgroup Analysis by Age Groups
	No IBD (n = 483,485)	IBD (n = 2,695)	Total (n = 486,180)	Unadjusted OR	95% CI	Adjusted OR	95% CI
No statistically significant findings were seen after subgroup analysis by age groups. IBD: inflammatory bowel disease; CI: confidence interval; OR: odds ratio.
Clinical outcomes for ages 18 - 64
Invasive mechanical ventilation	9.47	8.91	9.47	0.93	0.70	1.25	0.648	0.99	0.72	1.37	0.964
In-hospital mortality	5.48	4.45	5.47	0.80	0.54	1.20	0.289	0.89	0.58	1.37	0.598
Clinical outcomes for ages 65+	n = 560,805	n = 3,055	n = 563,860
Invasive mechanical ventilation	10.2	11.46	10.21	1.14	0.89	1.46	0.304	1.27	0.98	1.64	0.07
In-hospital mortality	16.09	15.55	16.09	0.96	0.77	1.20	0.72	01.02	0.81	1.29	0.85

Table 3. Subgroup Analysis by Age Groups

No IBD (n = 483,485)

IBD (n = 2,695)

Total (n = 486,180)

Unadjusted OR

95% CI

Adjusted OR

95% CI

Lower

Upper

P value

Lower

Upper

P value

No statistically significant findings were seen after subgroup analysis by age groups. IBD: inflammatory bowel disease; CI: confidence interval; OR: odds ratio.

Clinical outcomes for ages 18 - 64

Invasive mechanical ventilation

9.47

8.91

9.47

0.93

0.70

1.25

0.648

0.99

0.72

1.37

0.964

In-hospital mortality

5.48

4.45

5.47

0.80

0.54

1.20

0.289

0.89

0.58

1.37

0.598

Clinical outcomes for ages 65+

n = 560,805

n = 3,055

n = 563,860

Invasive mechanical ventilation

10.2

11.46

10.21

1.14

0.89

1.46

0.304

1.27

0.98

1.64

0.07

In-hospital mortality

16.09

15.55

16.09

0.96

0.77

1.20

0.72

01.02

0.81

1.29

0.85