Risk and Complications Associated with IBD

24 views 2 04/18/2020 05/01/2020

  1. No increased risk of contracting Covid-19 have been proved for patients  with inflammatory bowel disease (IBD) with present available data1.  
  2. Potential risk factors of SARS-CoV-2 infection for IBD patients is suspected if 2 :
    • Immunosuppressive agents are taken
    • The disease is in an active-stage combined with malnutrition
    • Patient frequently visits medical clinic
    • Underlying health conditions are present
    • Pregnancy is present
  3. Increased risks of serious and opportunistic infections have been found for patient taking adalimumab in a pooled analysis of 2266 patients3.
    • Risk of contracting opportunistic infection seems higher with IBD patients older than 50 years and taking immunosuppressant3.
  4. Patients who have severe IBD and COVID-19 would be more prone to be hospitalized due to their IBD or COVID-19 conditions5.
  5. Having a ostomy or J-pouch does not increase the risk for COVID-194.

 

This data comes from 5 different publications. Monteleone G., et al wrote a Viewpoint to present an overview of factors and mechanisms of how SARS-CoV-2 could infect the cells and identify links with IBD. Mao R., et al present a comment about available data of management of patient with pre-existing digestive diseases. Zingone F., et al present a Correspondence to talk about to use of biologics and risks of virus infection. Rubin DT., et al have written a manuscript reformatted as a Commentary to reunited the opinion of 89 experts of The international Organization for the Study of Inflammatory Bowel Diseases (IOIBD). They have summarized the management of IBD patient in the COVID-19 pandemic. Rubin DT, Feuerstein JD.,  et al present an expert commentary to review emerging evidence and provide expert recommendations for the management of IBD patients.

Sources :

  1. Monteleone G., Ardizzone S. (March 26, 2020). Are patients with inflammatory bowel disease at increased risk for Covid-19 infection? Journal of Crohn’s and Colitis, Oxford academic. https://doi.org/10.1093/ecco-jcc/jjaa061
  2. Mao R., Liang J., Shen J., Ghosh S., et al. (March 11, 2020). Implications of COVID-19 for patients with pre-existing digestive diseases. Lancet Gastroenterol Hepatol 2020. https://doi.org/10.1016/S2468-1253(20)30076-5
  3. Zingone F. (March 25, 2020). Viral screening before initiation of biologics in patients with inflammatory bowel disease during the COVID-19 outbreak. Lancet Gastroenterol Hepatol 2020. https://doi.org/10.1016/S2468-1253(20)30085-6
  4. Rubin DT., Abreu MT., Rai V., et al. (April 06, 2020). Management of Patients with Crohn’s Disease and Ulcerative Colitis During the COVID-19 Pandemic. Science Direct Journals & books. https://doi.org/10.1053/j.gastro.2020.04.002
  5. Rubin DT, Feuerstein JD, Wang AY, Cohen RD. (April 10, 2020). AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary. American Gastroenterology Association, Gastroenterology. doi: https://doi.org/10.1053/j.gastro.2020.04.012.  
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