PT  - JOURNAL ARTICLE
AU  - James John Ashton
AU  - Jochen Kammermeier
AU  - Christine Spray
AU  - Richard K Russell
AU  - Richard Hansen
AU  - Lucy J Howarth
AU  - Franco Torrente
AU  - Protima Deb
AU  - Elizabeth Renji
AU  - Rafeeq Muhammed
AU  - Thankam Paul
AU  - Fevronia Kiparissi
AU  - Jenny Epstein
AU  - Maureen Lawson
AU  - Ben Hope
AU  - Veena Zamvar
AU  - Priya Narula
AU  - Ahmed Kadir
AU  - David Devadason
AU  - Hemant Bhavsar
AU  - Robert Mark Beattie
TI  - Impact of COVID-19 on diagnosis and management of paediatric inflammatory bowel disease during lockdown: a UK nationwide study
AID  - 10.1136/archdischild-2020-319751
DP  - 2020 Dec 01
TA  - Archives of Disease in Childhood
PG  - 1186--1191
VI  - 105
IP  - 12
4099  - http://adc.bmj.com/content/105/12/1186.short
4100  - http://adc.bmj.com/content/105/12/1186.full
SO  - Arch Dis Child2020 Dec 01; 105
AB  - Background COVID-19 has impacted on healthcare provision. Anecdotally, investigations for children with inflammatory bowel disease (IBD) have been restricted, resulting in diagnosis with no histological confirmation and potential secondary morbidity. In this study, we detail practice across the UK to assess impact on services and document the impact of the pandemic.Methods For the month of April 2020, 20 tertiary paediatric IBD centres were invited to contribute data detailing: (1) diagnosis/management of suspected new patients with IBD; (2) facilities available; (3) ongoing management of IBD; and (4) direct impact of COVID-19 on patients with IBD.Results All centres contributed. Two centres retained routine endoscopy, with three unable to perform even urgent IBD endoscopy. 122 patients were diagnosed with IBD, and 53.3% (n=65) were presumed diagnoses and had not undergone endoscopy with histological confirmation. The most common induction was exclusive enteral nutrition (44.6%). No patients with a presumed rather than confirmed diagnosis were started on anti-tumour necrosis factor (TNF) therapy.Most IBD follow-up appointments were able to occur using phone/webcam or face to face. No biologics/immunomodulators were stopped. All centres were able to continue IBD surgery if required, with 14 procedures occurring across seven centres.Conclusions Diagnostic IBD practice has been hugely impacted by COVID-19, with >50% of new diagnoses not having endoscopy. To date, therapy and review of known paediatric patients with IBD has continued. Planning and resourcing for recovery is crucial to minimise continued secondary morbidity.