Has the COVID-19 Pandemic Affected the Clinical Severity and Incidence of Inflammatory Bowel Disease in Children?

Aim: It is known that SARS-CoV-2 enters the body by binding to angiotensin-converting enzyme-2 (ACE-2) receptors. Given that the gastrointestinal tract is rich in ACE-2 receptors, we hypothesized that SARS-CoV-2 may have increased the frequency, disease activation, and clinical presentation of inflammatory bowel disease (IBD). Methods: The study was conducted in two phases, each spanning a duration of three years. The first phase corresponded to the pre-pandemic period, which spanned from January 2017 to February 2020. The second phase encompassed the pandemic period from February 2020 to January 2023. The IBD diagnoses were recorded in 25 patients in the pre-pandemic period and 41 patients in the pandemic period, retrospectively. Results: The ratio of the number of patients admitted to the outpatient clinic and the number of procedures performed was significantly higher in the pre-pandemic and pandemic periods (17.53% vs. 25.81%, p<0.001). However, the ratio of patients diagnosed with IBD and the number of procedures performed exhibited a significantly higher value during the pandemic period compared to the pre-pandemic period (1.76% vs. 3%, p<0.001). C-reactive protein (CRP) level of the patients included in the study in the pandemic period was significantly higher compared to the pre-pandemic period (2.95 vs. 50, p<0.001). Conclusions: The present study has revealed that the prevalence of IBD has increased in children during the course of the ongoing pandemic of the novel coronavirus, SARS-CoV-2, also known as “COVID-19.” It is therefore recommended that children presenting with gastrointestinal tract complaints and possible cases of SARS-CoV-2 infection undergo evaluation for IBD.