Impact of COVID-19 for patients with IBD investigated in Nottingham | Latest news

In the Nottingham area alone, 5,000 people are living with serious bowel conditions which are collectively known as Inflammatory Bowel Disease (IBD). IBD is characterised by chronic inflammation of the patient’s gastrointestinal (GI) tract, which requires regular monitoring and treatment by health professionals.

In the first of the two studies, research is underway at both Queen’s Medical Centre (QMC) and Nottingham City Hospital looking at how doctors have responded to treating patients with flare-ups in IBD during the COVID-19 pandemic.

NUH is one of several centres participating in PREPARE-IBD, an observational study sponsored by Hull University Teaching Hospital NHS Trust.

IBD is an umbrella term for ulcerative colitis and Crohn’s disease, two long-term conditions that involve the inflammation of the intestine.

The Gastroenterology research team led by Associate Professor Dr Gordon Moran, of the NIHR Nottingham Biomedical Centre Gastrointestinal and Liver Theme (pictured), is recruiting around 30 outpatients – who will form part of the national cohort of 1,500 participants – whose data will be captured anonymously.

One supposition, which is yet to be proven, is because patients take immunosuppressant drugs as part of their IBD treatment regime, they may be more susceptible to COVID-19. There could also be more admissions to intensive care among these patients, and possibly worse outcomes for those with COVID-19.

Outpatients aged over 16 including those who have been hospitalised with IBD (or with both IBD and COVID-19) between 1 March and 30 June, 2020, are eligible to be part of PREPARE-IBD. The study is also open to those who are self-isolating with COVID-19 symptoms or who have tested positive with COVID-19 during the study period.

The study is also open to patients with active IBD who have been identified during the study timeframe. Their criteria include having increased IBD severe symptoms – known as a “flare-up” - in their disease.

Comparisons will be made with a control groupof patients not affected by COVID-19. This control group will include around 30 patients with the same inclusion criteria but who were being treated last year (during March and June 2019).

Researchers are currently identifying suitable patients for inclusion in this study. Final study data will be reported to the British Society of Gastroenterology, to help update patient treatment guidelines.

The same team is also leading the research for a second GI-related study, known as PROTECT-ASUS.

This study will recruit 10 inpatients at either the QMC or Nottingham City Hospital who are being treated for acute severe ulcerative colitis (ASUC).

Dr Moran is being supported by Research Fellow, Dr Frank Phillips, and Senior Research Nurse, Shellie Jean Radford, on this study, who are also working with him on PREPARE-IBD.

PROTECT-ASUC is collecting retrospective data of routine NHS care of a cohort of ASUC patients across the UK. The objective is to determine the impact any changes in the management of ASUC during the Coronavirus pandemic have made in terms of clinical outcomes for patients who have been hospitalised with ASUC. 

Acute severe ulcerative colitis is a severe gastrointestinal disease, which if left untreated at its worse can lead to bleeding, perforation of the bowel and, at its worst, a patient fatality.

The study aims to evaluate the process, evaluation and therapy variation in management of ASUC compared to 2019 British Society of Gastroenterology guidelines, and see whether there are any differences between ambulatory and hospital management in ASUC. PROTECT-ASUS opened for recruitment in May and the study is expected to conclude later this month.