P0546 - A National Cohort of IBD Patients Exhibit Strong COVID-19 Safety Practice Beliefs

Sunday, October 24, 2021

3:30 PM – 7:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Erica R. Cohen, MD

Capital Digestive Care
Chevy Chase, MD, United States

Erica R. Cohen, MD¹, Gregory J. Botwin, BS², Brigid Boland, MD³, Michael Chiorean, MD⁴, David Fudman, MD⁵, Jason Hou, MD, MS⁶, Caroline Hwang, MD⁷, Mark Lazarev, MD⁸, Donald F. Lum, MD, FACG⁹, Mark C. Mattar, MD¹⁰, Ryan McConnell, MD¹¹, Arthur Ostrov, MD, FACG¹², Douglas C. Wolf, MD¹³, Ziad Younis, MD¹⁴, Bradley Morganstern, MD¹⁵, Arash Horizon, MD¹⁶, Keren L. Appel, MD¹⁷, Rashmi Kumar, MD¹⁷, Swamy Venuturupalli, MD¹⁸, Daniel J. Wallace, MD¹⁹, Sarah Glover, DO²⁰, Christina Ha, MD, FACG²¹, Gaurav Syal, MD, MHDS¹⁷, Andrea Banty, FNP¹⁷, Shervin Rabizadeh, MD, MBA¹⁷, Edward J. Feldman, MD¹⁷, Susie K. Lee, FNP¹⁷, Theodore Stein, MD²², Susan Cheng, MD, MPH¹⁷, Gil Melmed, MD¹⁷, Dermot McGovern, MD, PhD, FACG, FRCP¹⁷, Jonathan Braun, MD, PhD¹⁷, Nimisha Parekh, MD, MPH²³
¹Capital Digestive Care, Chevy Chase, MD; ²F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA; ³University of California San Diego, La Jolla, CA; ⁴Virginia Mason Hospital, Seattle, WA; ⁵University of Texas Southwestern Medical Center, Dallas, TX; ⁶Baylor College of Medicine; Michael E. DeBakey VA Medical Center, Houston, TX; ⁷Margolis Family Inflammatory Bowel Disease (IBD) Program at Hoag, Irvine, CA; ⁸Johns Hopkins University School of Medicine, Baltimore, MD; ⁹The Oregon Clinic, Gastroenterology East, Portland, OR; ¹⁰MedStar Georgetown University Hospital, Washington, DC; ¹¹Sutter Health, Palo Alto, CA; ¹²Saratoga Schenectady Gastroenterology Associates, Burnt Hills, NY; ¹³Center for Crohn’s Disease & Ulcerative Colitis, Atlanta Gastroenterology Associates, Atlanta, GA; ¹⁴Gastro One, Germantown, TN; ¹⁵Stony Brook University Hospital, East Setauket, NY; ¹⁶Center for Rheumatology, Los Angeles, CA; ¹⁷Cedars-Sinai Medical Center, Los Angeles, CA; ¹⁸Attune Health, Los Angeles, CA; ¹⁹Cedars-Sinai Medical Center, Beverly Hills, CA; ²⁰University of Mississippi Medical Center, Jackson, MS; ²¹Inflammatory Bowel Disease Center, Cedars-Sinai Medical Center, Los Angeles, CA; ²²Cedars-Sinai Medical Group, Los Angeles, CA; ²³H. H. Chao Comprehensive Digestive Disease Center, University of California Irvine, Orange, CA

Introduction: Support for, and adherence to, public health recommendations during the COVID-19 pandemic has been highly variable, challenging the country’s ability to control viral transmission. Two-thirds of the general population support social distancing and mask wearing but there is significant variation by demographic and trust in science (PMID 33734840). We sought to understand COVID-19 practice beliefs among vaccinated inflammatory bowel disease (IBD) patients.

Methods: We administered a survey between December 2020 and June 2021 to adults with IBD subjects planning on receiving a COVID-19 vaccine and enrolled in the Coronavirus Risk Associations and Longitudinal Evaluation-IBD (CORALE-IBD) study. Subjects were asked to rate the effectiveness of 10 practices for keeping them safe from COVID-19 on a 5-point Likert scale. The sum of the values for each question was used to create a composite COVID-19 practice beliefs metric (maximum score of 50). Responses in which the participant believed the practice was at least “somewhat effective” were classified as a practice belief. We performed univariate analysis to assess differences in group means.

Results: The cohort included 1496 subjects (Table 1). Mean composite belief scores were high 43.25 (IQR 40-50). Ninety-eight percent of subjects believed wearing a face mask and avoiding hospitals or clinics were effective strategies at mitigating COVID transmission. While, 85% of subjects believed temperature checks before entering a building were effective (Image 1). Females (43.64 vs 42.49; p=0.01), those who were not infected with COVID-19 (43.44 vs 40.30; p=0.001), and subjects who lost their job during the pandemic (44.36 vs 42.27(all comparisons); p< 0.001), had more stringent practice beliefs. There were no differences based on IBD type, ethnicity, income level or employment status.

Discussion: Variation in acceptance of public health messaging has been a barrier to viral containment during the COVID-19 pandemic. We show that, even during the later phases of reopening, this national cohort maintained consistently high belief in non-pharmacologic public health guidance. An opportunity remains to reassure patients that seeking medical care in clinics and hospitals is safe and should not be deferred. Practice beliefs in this cohort are higher than historical controls, but further comparisons are needed.

Figure: Percentage of affirmed practice beliefs

Variable	Overall (n=1496)
Male (%)	435 (33)
Prior COVID-19 Infection (%)	68 (5.2)
Type of COVID-19 Vaccine Received Moderna mRNA-1273 Vaccine (%) Pfizer Vaccine BNT162b2 (%) Johnson and Johnson (%)	515 (38.8) 755 (57.0) 56 (4.2)
Ulcerative colitis/indeterminant colitis (%)	540 (36.1)
Race Caucasian (%) Black (%) Latinx (%)	1328 (88.7) 118 (8.9) 45 (3.4)
Education Some high school (%) High School + (%) College Degree (%) Some school after college or advanced degree (%)	5 (0.4) 194 (12.9) 383 (31.8) 645 (52.4)
Marital Status Single (%)	432 (32.7)
Employment Status Employed (%) Student (%) Not working (%) Retired (%) Disabled (%)	899 (60.0) 49 (4.0) 36 (2.9) 99 (8.0) 57 (4.6)
Annual Income $0-$34,999 $35,000 - $74,999 $ 75,000 +	209 (17.2) 264 (21.7) 581 (47.7)

Table: Descriptive Characteristics of Subject Demographics

Disclosures:
Erica Cohen: Abbvie – Speaker's Bureau. Pfizer – Consultant.
Gregory Botwin indicated no relevant financial relationships.
Brigid Boland indicated no relevant financial relationships.
Michael Chiorean: Abbvie – Consultant, Speaker's Bureau. Arena – Consultant. BMS – Advisory Committee/Board Member, Speaker's Bureau. Janssen – Advisory Committee/Board Member, Speaker's Bureau. Lilly – Consultant. Medtronic – Consultant, Speaker's Bureau. Pfizer – Advisory Committee/Board Member, Speaker's Bureau. Takeda – Speaker's Bureau.
David Fudman: Pfizer – Advisory Committee/Board Member.
Jason Hou indicated no relevant financial relationships.
Caroline Hwang: Abbvie – Grant/Research Support. Janssen – Speaker's Bureau. Pfizer – Advisory Committee/Board Member, Speaker's Bureau.
Mark Lazarev indicated no relevant financial relationships.
Donald Lum: AbbVie – Consultant, Speaker's Bureau. Janssen – Consultant, Speaker's Bureau. Takeda – Speaker's Bureau.
Mark Mattar indicated no relevant financial relationships.
Ryan McConnell: AbbVie – Advisory Committee/Board Member, Speaker's Bureau. Pfizer – Speaker's Bureau. Prometheus Biosciences – Advisory Committee/Board Member.
Arthur Ostrov indicated no relevant financial relationships.
Douglas Wolf: Abbvie – Grant/Research Support, Speaker's Bureau. Arena – Consultant, Grant/Research Support. bristol Myers Squibb – Grant/Research Support. Corevitas (Corrona) – Consultant, Grant/Research Support. Janssen – Consultant, Grant/Research Support, Speaker's Bureau. Lilly – Consultant. Pfizer – Consultant, Speaker's Bureau. Takeda – Consultant, Grant/Research Support, Speaker's Bureau.
Ziad Younis indicated no relevant financial relationships.
Bradley Morganstern: Abbvie – Speaker's Bureau. Bristol Myers Squibb – Speaker's Bureau. Janssen – Speaker's Bureau. Pfizer – Speaker's Bureau. Takeda – Speaker's Bureau.
Arash Horizon indicated no relevant financial relationships.
Keren Appel indicated no relevant financial relationships.
Rashmi Kumar indicated no relevant financial relationships.
Swamy Venuturupalli indicated no relevant financial relationships.
Daniel Wallace indicated no relevant financial relationships.
Sarah Glover: Abbvie – Speaker's Bureau. Janssen – Consultant. Takeda – Speaker's Bureau.
Christina Ha: Abbvie – Advisory Committee/Board Member. Bristol Meyers Squibb – Advisory Committee/Board Member. Genentech – Advisory Committee/Board Member, Grant/Research Support. InDex Pharmaceuticals – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Lilly – Advisory Committee/Board Member, Grant/Research Support. Pfizer – Advisory Committee/Board Member, Grant/Research Support.
Gaurav Syal: Pfizer – Grant/Research Support, Stockholder/Ownership Interest (excluding diversified mutual funds).
Andrea Banty indicated no relevant financial relationships.
Shervin Rabizadeh: prometheus bioscience – Advisory Committee/Board Member.
Edward Feldman indicated no relevant financial relationships.
Susie Lee indicated no relevant financial relationships.
Theodore Stein indicated no relevant financial relationships.
Susan Cheng indicated no relevant financial relationships.
Gil Melmed: Abbvie – Consultant. Arena – Consultant. Boehringer-Ingelheim – Consultant. Bristo-Meyers Squibb / Celgene – Consultant. Entasis – Consultant. Janssen – Consultant. Medtronic – Consultant. Nephroceuticals – Consultant, Stockholder/Ownership Interest (excluding diversified mutual funds). Pfizer – Consultant, Grant/Research Support. Samsung Bioepis – Grant/Research Support. Shionogi – Other Financial or Material Support, DSMB. Takeda – Consultant. Techlab – Consultant.
Dermot McGovern: Bridge Biotherapeutics – Consultant. Gilead – Consultant. Palatin – Consultant. Pfizer – Consultant. Prometheus Biosciences – Consultant, Patent Holder, Stockholder/Ownership Interest (excluding diversified mutual funds). Prometheus laboratories – Consultant, Stockholder/Ownership Interest (excluding diversified mutual funds). Takeda – Consultant.
Jonathan Braun indicated no relevant financial relationships.
Nimisha Parekh: pfizer – Consultant.

Erica R. Cohen, MD¹, Gregory J. Botwin, BS², Brigid Boland, MD³, Michael Chiorean, MD⁴, David Fudman, MD⁵, Jason Hou, MD, MS⁶, Caroline Hwang, MD⁷, Mark Lazarev, MD⁸, Donald F. Lum, MD, FACG⁹, Mark C. Mattar, MD¹⁰, Ryan McConnell, MD¹¹, Arthur Ostrov, MD, FACG¹², Douglas C. Wolf, MD¹³, Ziad Younis, MD¹⁴, Bradley Morganstern, MD¹⁵, Arash Horizon, MD¹⁶, Keren L. Appel, MD¹⁷, Rashmi Kumar, MD¹⁷, Swamy Venuturupalli, MD¹⁸, Daniel J. Wallace, MD¹⁹, Sarah Glover, DO²⁰, Christina Ha, MD, FACG²¹, Gaurav Syal, MD, MHDS¹⁷, Andrea Banty, FNP¹⁷, Shervin Rabizadeh, MD, MBA¹⁷, Edward J. Feldman, MD¹⁷, Susie K. Lee, FNP¹⁷, Theodore Stein, MD²², Susan Cheng, MD, MPH¹⁷, Gil Melmed, MD¹⁷, Dermot McGovern, MD, PhD, FACG, FRCP¹⁷, Jonathan Braun, MD, PhD¹⁷, Nimisha Parekh, MD, MPH²³. P0546 - A National Cohort of IBD Patients Exhibit Strong COVID-19 Safety Practice Beliefs, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.