The impact of the COVID-19 pandemic on the course of Clostridioides difficile infection in patients with inflammatory bowel disease

Introduction: Patients with inflammatory bowel disease (IBD) are at high risk of Clostridioides difficile infection (CDI). The Coronavirus disease 2019 (COVID-19) pandemic was a special time, that had an impact on the course of many diseases. This study aimed to determine the influence of the COVID-19 pandemic on the course of CDI in patients with ulcerative colitis (UC) and Crohn’s disease (CD). Material and methods: A retrospective study involved a total of 61 patients and compared the course of CDI in IBD patients in the pre-pandemic period (2015–2020) and after the second wave of COVID-19 (2022–2023). The analysis included demographic, clinical, laboratory data, and CDI risk factors. The course of CDI was divided into benign, severe, and severe-complicated. Results: In five years before the pandemic in IBD patients, there were 35 cases of CDI, whereas in 15 months after the first COVID-19 wave, there were 31 CDI. In the quartile comparison, the CDI incidence increased in the pandemic period (p = 0.021). The antibiotherapy wasn’t a significant factor in increasing the CDI incidence. Patients with UC comprised 85.71% of the control group and 67.74% of the treatment group. The authors obtained a statistically significant higher rate of using an increased vancomycin dose (p = 0.010) and recurrences of CDI (p = 0.045) in the totality of IBD patients and only with ulcerative colitis (p = 0.001), (p = 0.020). Conclusions: The COVID-19 pandemic contributed to an increase in CDI incidence in IBD patients. The infections require treatment intensification and are characterized by increased recurrence, especially in patients with UC.