P324 Long-term impact of the COVID-19 pandemic on Inflammatory Bowel Disease healthcare utilization: A two-year nationwide update

DerksEduarda Wilhelmina, M.(1)*;van Lierop, L.(2);te Groen, M.(1);Kuijpers, C.(3);Nagtegaal, I.D.(4);Hoentjen, F.(2);

(1)Radboud University Medical Centre, Department of Gastroenterology and Hepatology, Nijmegen, The Netherlands;(2)University of Alberta, Department of Medicine- Division of Gastroenterology, Edmonton, Canada;(3)PALGA Foundation, Pathology, Houten, The Netherlands;(4)Radboud Univserity Medical Centre, Department of Pathology, Nijmegen, The Netherlands;


The COVID-19 pandemic has profoundly impacted utilization of inflammatory bowel disease (IBD) healthcare, with a large reduction in scheduled procedures in the early phase of the pandemic, as shown in our previous study1. In this current nationwide study, we aimed to determine the impact of consecutive COVID-19 waves on IBD healthcare utilization including IBD-related diagnoses and procedures during the first two years of the COVID-19 pandemic.


We conducted a search in the Dutch nationwide pathology databank (PALGA) to identify IBD patients who underwent an IBD-related procedure between March 1, 2018 and February 28, 2022. We determined the incidence of IBD-related endoscopic and surgical procedures, new IBD diagnoses and neoplasia diagnoses (indefinite (IND), low-grade (LGD), high-grade dysplasia (HGD) and colorectal cancer (CRC)) during the first two years of the COVID-19 pandemic in the Netherlands (March 2020 – February 2022). The mean incidence of the previous two years (March 2018 – February 2020) served as a comparator.


Our search yielded 89,401 (94.2%) endoscopic and 5,462 (5.8%) surgical procedures. We calculated a net reduction of 2.9% (1,391 IBD procedures) after the first two years of the COVID-19 pandemic compared to the two pre-pandemic years (endoscopic procedures: -3.1%, n=1,409; surgical procedures: +0.7%, n=18, figure 1). For both endoscopic and surgical procedures, an initial net decrease after the first pandemic year was followed by a net increase after the second year (-6.2% (n=1,413) versus +0.02% (n=4) and -1.3% (n=18) versus +2.7% (n=36), respectively). A net reduction of 0.9% (n=54) in new IBD diagnoses was observed over the first two years of the COVID-19 pandemic (first year: -0.8%, n=24; second year: -1.0%, n=30). A net reduction of 1.9% (n=74) in IND/LGD diagnoses was observed after the two-year pandemic period (first year: -10.9%, n=213: second year: +7.1%, n=139). No net decrease was seen for HGD and CRC diagnoses.


In this nationwide cohort study covering the first two pandemic years, we observed a mitigation of the initial reduction of IBD-related procedures after the first COVID-19 wave. This illustrates the rapid adaptation of the national IBD healthcare system during subsequent COVID-19 peaks.

1 te Groen M, Derks MEW, Kuijpers CCHJ, Nagtegaal ID, Hoentjen F. Reduction in Inflammatory Bowel Disease Healthcare During the Coronavirus Disease 2019 Pandemic: A Nationwide Retrospective Cohort Study. Gastroenterology. 2021;160(3):935-7.e1