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Sunday Poster Session

Category: Esophagus

P0424 - Examining Characteristics of Eosinophilic Esophagitis Patients Presenting to the Hospital With COVID-19

Sunday, October 22, 2023
3:30 PM – 7:00 PM PT
Location: Exhibit Hall
Lovepreet Singh, MD1, Ramanpreet Bajwa, DO2, Andrew Ford, MD1, Prashanthi N. Thota, MD1, Scott Gabbard, MD1, Yi Qin, MD1, Claire Beveridge, MD1
1Cleveland Clinic Foundation, Cleveland, OH; 2Cleveland Clinic Foundation, Shaker Heights, OH

Introduction: Eosinophilic Esophagitis (EoE) is a chronic esophageal inflammatory condition esophagus that is rising in prevalence and incidence. The COVID-19 pandemic has impacted patients with chronic conditions, but there is limited data on EoE. Our aims are: 1) to describe the EoE cohort with COVID-19 requiring the emergency department (ED) or hospital admission, and 2) identify predictors for requiring higher level of care.

Methods: We performed a retrospective study from July 2020 to March 2023 at our institution. Inclusion criteria included adults with histologically proven EoE, positive COVID-19 PCR test, and presentation to the ED or hospital. Descriptive statistics were used. Multivariate logistic regression analysis was performed to assess for predictors, controlling for lung disease, tobacco use, obesity, hypertension, type 2 diabetes mellitus and autoimmune conditions. Comparisons were made between: 1) ED and observation versus admission and 2) ICU versus all others. Fibrostenosis was defined as rings and/or strictures using the EoE Endoscopic Reference Score. Active EoE was defined as ≥15 eosinophils per high power field.

Results: 76 patients were included in the analysis: 55 patients were seen in the ED or observation unit, and 21 patients were hospitalized. ICU care was required in 5% of patients. Table 1 shows the description of the cohort. Hospitalized patients were significantly older than the patients in the ED or observation unit (p=0.0451) (Table 1). Treatment with remdesivir and dexamethasone was used in 66.7% of the hospitalized patients, and supplemental oxygen was needed in 17% of patients. Receiving COVID-19 vaccinations, lack of fibrostenosis and histologic remission did not decrease the risk of inpatient hospitalization compared with being in the ED or observation. Patients who were white trended to have a higher likelihood of requiring ICU admission (OR 1.50: 95% CI 0.75-3.02, p=0.25).

Discussion: In EoE patients with COVID-19 presenting to the ED or hospital, COVID-19 can be severe enough to require hospital admission for over a quarter of patients. However, there were low rates of ICU care and thrombosis. Future goals include assessing severity of COVID-19 with control patients to better understand predictors.
  All Patients
(n=76)		Patients in the Emergency Department or Observation Unit(n=55) Hospitalized Patients (n=21)
 Demographics    
 Age (mean years) 46 43.4 (SD±14.12) 51.6 (SD±19.29)
 Sex (Male) 60% 61% 59.1%
 BMI >30 kg/m² 49% 57% 31.8%
 Tobacco use 30% 27.3% 38.1%
 Lung Disease 30% 24.1% 45.5%
 Hypertension 36% 38.9% 31.8%
 Diabetes Mellitus II 9.2% 9.3% 13.6%
 Hyperlipidemia 23% 24.1% 22.7%
 Eosinophilic Esophagitis Demographics and History 
 Food impaction history  25% 25.9% 22.7%
 Allergic rhinitis   68% 70.4% 68.2%
 Food allergies   36% 38.9% 31.8%
 Asthma    57% 61.1% 45.5%
 Active EoE  68% 67.3% 71.4%
 Fibrostenosis   53% 56.4% 42.9%
 COVID-19 demographics 
 Vaccinated  76% 75.9% 77%
 Booster Received  49% 46.3% 59.1%
 Emergency Department and Hospitalization 
 Supplemental Oxygen   17% 0% 61.9%
 ICU Admission   5% 0% 19.1%
 Treatment with Remdesivir & dexamethasone  18% 0% 66.7%
 30 day Thrombosis   5% 0% 19.2%

Table: Table 1. Descriptive Characteristics of EoE Patients with COVID-19 Infection
(Lung disease defined as Chronic Obstructive Pulmonary Disease, Emphysema, Chronic Bronchitis, Sarcoid, obstructive Sleep Apnea)


Disclosures:
Lovepreet Singh indicated no relevant financial relationships.
Ramanpreet Bajwa indicated no relevant financial relationships.
Andrew Ford indicated no relevant financial relationships.
Prashanthi Thota indicated no relevant financial relationships.
Scott Gabbard indicated no relevant financial relationships.
Yi Qin indicated no relevant financial relationships.
Claire Beveridge: Bionest Partners – Consultant. Lucid Diagnostics Inc – Consultant.


Lovepreet Singh, MD1, Ramanpreet Bajwa, DO2, Andrew Ford, MD1, Prashanthi N. Thota, MD1, Scott Gabbard, MD1, Yi Qin, MD1, Claire Beveridge, MD1. P0424 - Examining Characteristics of Eosinophilic Esophagitis Patients Presenting to the Hospital With COVID-19, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.