Summary: | <p><strong>Objectives:</strong> A link between <span data-value="stress">stress</span> and <span data-value="Crohn’s disease">Crohn’s disease</span> activity suggests an association, but results have been conflicting. The purpose of this study was to assess whether the <span data-value="stress">stress</span> related to the <span data-value="coronavirus disease 2019">coronavirus disease 2019</span> (COVID-19) pandemic affected disease activity in patients with <span data-value="Crohn’s disease">Crohn’s disease</span>.</p>
<p><strong>Basic methods:</strong> An anonymous survey was distributed to patients through gastroenterology clinics and networks. Patients were asked to report their <span data-value="Crohn’s disease">Crohn’s disease</span> symptoms in the months prior to the COVID-19 pandemic and again during the early stages of the COVID-19 pandemic using the Manitoba inflammatory bowel disease index in addition to questions about <span data-value="stress">stress</span>, perception of reasons for symptom change and personal impact.</p>
<p><strong>Main results:</strong> Out of 243 individuals with a confirmed diagnosis of <span data-value="Crohn’s disease">Crohn’s disease</span>, there was a 24% relative increase in active symptoms between the pre-COVID-19 period to the during-COVID-19 period (<em>P</em> < 0.0001) reflecting an absolute change from 45 to 56%, respectively. The most frequent reported reason for a change in symptoms was ‘Increased <span data-value="stress">stress</span>/and or feeling overwhelmed’ (118/236), and personal impact of the pandemic was, ‘I’m worrying a lot about the future’ (113/236), both reported by approximately half of respondents.</p>
<p><strong>Principal conclusions:</strong> This study serves as a ‘proof of concept’ demonstrating the impact of a significant and uniquely uniform stressor as a natural experiment on <span data-value="Crohn’s disease">Crohn’s disease</span> activity. The severity of symptoms of <span data-value="Crohn’s disease">Crohn’s disease</span> increased during the COVID-19 pandemic. The primary reported reason for symptom change was an increase in <span data-value="stress">stress</span>, not a change in diet, exercise or other lifestyle behaviours, corroborating the hypothesis that <span data-value="stress">stress</span> affects <span data-value="Crohn’s disease">Crohn’s disease</span> activity.</p>
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