J Korean Med Sci.  2022 Sep;37(37):e279. 10.3346/jkms.2022.37.e279.

Epidemiological Trends of Pediatric Inflammatory Bowel Disease in Korea: A Multicenter Study of the Last 3 Years Including the COVID-19 Era

Affiliations
  • 1Department of Pediatrics, Kosin University College of Medicine, Kosin University Gospel Hospital, Busan, Korea
  • 2Department of Pediatrics, School of Medicine, Kyungpook National University, Kyungpook National University Children’s Hospital, Daegu, Korea
  • 3Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
  • 4Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
  • 5Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Korea
  • 6Department of Pediatrics, Dankook University Hospital, Cheonan, Korea
  • 7Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
  • 8Department of Pediatrics, Jeju National University Hospital, Jeju, Korea
  • 9Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
  • 10Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
  • 11Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 12Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
  • 13Department of Pediatrics, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea
  • 14Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
  • 15Department of Pediatrics, Inje University College of Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 16Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
  • 17Department of Pediatrics, Jeonbuk National University Medical School and Hospital, Jeonju, Korea
  • 18Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea

Abstract

Background
Studies on how the coronavirus pandemic has affected pediatric inflammatory bowel disease (PIBD) are lacking. We aimed to investigate the trends in epidemiology, characteristics, initial management, and short-term outcomes of PIBD in South Korea over the recent three years including the era of coronavirus disease 2019 (COVID-19).
Methods
This multicenter study retrospectively investigated temporal trends in the epidemiology of PIBD in Korea. Annual occurrences, disease phenotypes, and initial management at diagnosis were analyzed from January 2018 to June 2021.
Results
A total of 486 patients from 17 institutions were included in this epidemiological evaluation. Analysis of the occurrence trend confirmed a significant increase in PIBD, regardless of the COVID-19 pandemic. In Crohn’s disease, patients with post-coronavirus outbreaks had significantly higher fecal calprotectin levels than those with previous onset 1,339.4 ± 717.04 vs. 1,595.5 ± 703.94, P = 0.001). Patients with post-coronavirus-onset ulcerative colitis had significantly higher Pediatric Ulcerative Colitis Activity Index scores than those with previous outbreaks (48 ± 17 vs. 36 ± 15, P = 0.004). In the initial treatment of Crohn’s disease, the use of 5-aminosalicylic acid (5-ASA) and steroids significantly decreased (P = 0.006 and 0.001, respectively), and enteral nutrition and the use of infliximab increased significantly (P = 0.045 and 0.009, respectively). There was a significant increase in azathioprine use during the initial treatment of ulcerative colitis (P = 0.020).
Conclusion
Regardless of the COVID-19 pandemic, the number of patients with PIBD is increasing significantly annually in Korea. The initial management trends for PIBD have also changed. More research is needed to establish appropriate treatment guidelines considering the epidemiological and clinical characteristics of Korean PIBD.

Keyword

Inflammatory Bowel Disease; Pediatric; COVID-19; Occurrence; Management

Figure

  • Fig. 1 The incidence of pediatric inflammatory bowel disease.CD = Crohn’s disease, UC = ulcerative colitis.


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