Comparative analysis of the course of COVID-19 and post-COVID syndrome in patients with inflammatory bowel disease and COVID-19 caused by the Omicron strain and earlier strains

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Abstract

BACKGROUND: Patients with inflammatory bowel disease have specific features of the course of COVID-19 and post-COVID syndrome. The available literature is limited in data comparing the course of COVID-19 of different strains in patients with inflammatory bowel disease as well as assessing the course of post-COVID syndrome.

AIM: To conduct a comparative analysis of the course of COVID-19 and post-covid syndrome in patients with inflammatory bowel disease and COVID-19 caused by the Omicron strain and earlier strains.

MATERIALS AND METHODS: The study included 159 patients diagnosed with ulcerative colitis and Crohn’s disease and COVID-19, who were observed in two temporary infectious diseases hospitals in Kazan (Republican Clinical Hospital and City Clinical Hospital No. 7) and on outpatient basis since April 2020 to May 2022. For a comparative analysis of the course of COVID-19 and post-COVID syndrome in patients who had come through COVID-19, 2 periods were defined: the 1st period — from March 2020 to December 2021, the 2nd period — from January 2022.

RESULTS: None of the patients with Omicron developed lung damage (0 (0%) vs 36 (44.4%), p < 0.05). It has been also found that among patients with Omicron there were more patients with comorbidity (62 (79.5%) versus 50 (61.7%), (p < 0.05).

Dynamic observation of the patients has revealed that post-covid syndrome was significantly less common in the patients with Omicron for 3 months after COVID-19 (25.6% vs. 47.1%).

When analyzing the complaints associated with asthenia, it was found that they were significantly more common in the patients with Omicron 3 months after COVID-19 (58 (74.3%) in comparison with 17 (50%), p < 0.05). The complaints associated with cognitive impairment (0 (0%) vs. 3 (8.8%), p < 0.05) and depression (Hospital Anxiety and Depression Scale (31 (39.7%) vs. 22 (64.7%), p < 0.05), Hamilton scale (22 (28.2%) vs. 22 (64.7%), p < 0.05)) were significantly less common in the patients with Omicron for 3 months after COVID-19.

After analyzing the activity in the patients with inflammatory bowel disease before COVID-19 and 3, 6, 9 months after COVID-19, we have found that the maximum number of patients with the exacerbation of inflammatory bowel disease was noted after 3 months in the patients with Omicron and after 6 months in the patients with earlier strains.

CONCLUSIONS: Thus, the results of the study have shown that in the patients with inflammatory bowel disease, both in ulcerative colitis and Crohn’s disease, the course of COVID-19 caused by the Omicron strain proceeded in a milder form compared with the patients who had earlier strains. In the patients with Omicron, complaints characteristic of post-COVID syndrome were less common. After a previous infection with COVID-19, the frequency of inflammatory bowel disease relapses increased: in the patients with Omicron due to mild exacerbation 3 months after COVID-19; in the patients with earlier strains — due to moderate and severe relapse.

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About the authors

Luciya M. Kupkenova

Kazan State Medical University; Republican Clinical Hospital

Author for correspondence.
Email: lkupkenova@mail.ru
ORCID iD: 0000-0003-2874-9462
SPIN-code: 1388-9222

MD

Russian Federation, 49 Butlerova St., Kazan, 420012; Kazan

Alfiya Kh. Odintsova

Republican Clinical Hospital

Email: odincovaa@yandex.ru
ORCID iD: 0000-0002-7148-8862

MD, Cand. Sci. (Med.)

Russian Federation, Kazan

Dilyara G. Iskhakova

City Clinical Hospital No. 7

Email: iskhakova_d@mail.ru
ORCID iD: 0000-0003-3829-5302

MD

Russian Federation, Kazan

Natalya A. Cheremina

Republican Clinical Hospital

Email: doctornat@mail.ru
ORCID iD: 0000-0002-5856-5050

MD

Russian Federation, Kazan

Diana I. Abdulganieva

Kazan State Medical University; Republican Clinical Hospital

Email: diana_s@mail.ru
ORCID iD: 0000-0001-7069-2725
SPIN-code: 6676-4270

MD, Dr. Sci. (Med.), Professor

Russian Federation, 49 Butlerova St., Kazan, 420012; Kazan

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Supplementary files

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2. Fig. 1. Frequency of manifestations of post-COVID syndrome in the patients with inflammatory bowel disease who had infection caused by Omicron and earlier strains on the 3rd, 6th and 9th months after COVID-19. I — shortness of breath and decreased exercise tolerance and/or chronic cough; II — chest pain and/or palpitations, swelling of the lower extremities; III — fatigue and/or muscle pain, headache, dysautonomy, cognitive impairment; IV — unstable course of diabetes mellitus (previously flowing stably) or the detection of diabetes mellitus; V — hair loss or skin rash; VI — pain in the joints; VII — loss of taste and/or smell; VIII — elevated body temperature since recovery. * p < 0.05

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3. Fig. 2. Inflammatory bowel disease (IBD) activity before and after COVID-19 in the patients suffered Omicron infection

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4. Fig. 3. Inflammatory bowel disease (IBD) activity before and after COVID-19 in the patients after infection with earlier strains

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