Fear of COVID-19 among persons with IBD according to employment status, educational background and residential setting, as compared to persons with other gastrointestinal conditions

Introduction: Although several studies have reported the impact of fears relating to COVID-19 on several chronic illness populations, there are few studies focused on gastrointestinal (GI) conditions1-4. The aim was to compare how fear of COVID-19 is manifested in people living with Inflammatory Bowel Disease (IBD) compared to other GI conditions;and, how fear of COVID-19 is manifested across different demographic backgrounds (employment status, education level and country of residence) among IBD respondents using a large international sample. Aims & Methods: Participants with a GI condition (≥18years of age) were recruited from 22 countries through a web-based questionnaire. Demographic, clinical, and psychosocial information was collected in relation to the COVID-19 pandemic. An adaptation of the scale developed for IBD by Trindade & Ferreira (2020)5 measuring fear of COVID-19 (FoC;original items 1-9) and GI specific fear of COVID-19 (GI-FoC;new items 10-14) was used. Results: In 831 participants (312 IBD), there were no significant differences in FoC between IBD and other GI conditions;whilst significant increases in GI-FoC were found in IBD respondents (mean [SD]: 13.5 [5.5] vs. 10.9 [5.0], p<0.01). The greatest fears of IBD respondents were: their condition would get worse;impact on access to medical support;being at increased risk of getting COVID-19;and being at increased risk of death if they got COVID-19. Among IBD respondents, persons on sick leave had significantly more FoC than those employed (median [IQR], 31.0 [28.5-39.5] vs 26.0 [20.0-33.0], p=0.035), and significantly more GI-FoC compared to the employed (18.0 [14.5-22.0] vs 13.0 [9.0-17.0], p=0.033) or respondents outside of the labour market (12.0 [7.0-16.0], p=0.022). Persons living in a rural setting had significantly more FoC compared to persons living in regional setting (29.5 [22.0-37.8] vs 25.0 [20.0-31.3], p=0.007) and GI-FoC (15.0 [11.0-19.8] vs 12.0 [9.0-16.0], p=0.02). These persons were fearful of contracting COVID-19, having contact with someone with respiratory symptoms, having contact with healthcare professionals, going outside, meeting people, having contact with someone who was in contact with an infected person, having contact with someone infected with COVID-19, and that their IBD means being at increased risk of death if they got COVID-19. There were no differences in general FoC and GI-FoC according to educational background. However, respondents with higher education were less afraid of dying from COVID-19. Conclusion: Respondents with IBD are more afraid of the consequences of COVID-19 due to their disease compared to other GI diseases;especially, persons on sick leave or persons living in a rural setting. Persons with higher education were less afraid of dying from COVID-19. These findings should be taken into consideration to personalise the support health care providers can offer in mitigating fear related to COVID-19 in IBD patients.