COVID-19 susceptibility  for individuals with IBD

With the rise of COVID-19 cases in the US, we wanted to shed some light on what this means for individuals with inflammatory bowel disease. Considering that IBD is a condition in which your immune system is overresponsive to perceived threats, you may wonder if that makes you more susceptible to contracting the COVID-19 virus or more likely to experience a severe case if you did contract it. There is limited research available indicating individuals with IBD are more susceptible to COVID-19 although it is generally recognized that there is an increased risk to contracting the virus when there is active bowel inflammation (a flare).(1)

IBD medications and COVID-19

Immunomodulating medications used for IBD have been reported to increase the risk of infections, which may include COVID-19. Specifically, immunosuppressants (azathioprine and 6-mercaptopurine) and JAK inhibitors (tofacitinib) modulate the immune response, potentially affecting the course of COVID-19, although there is currently no data to support this.(2) According to the Crohn’s and Colitis Foundation, aminosalicylates (such as mesalamine) do not suppress your immune system nor raise your risk to COVID-19. A recent study by SECURE-IBD, an international database monitoring report outcomes of COVID-19 in IBD patients, found that corticosteroids are associated with adverse COVID-19 outcomes in patients with IBD, while anti-TNF medications were not associated with adverse outcomes.(3) If you are on high dose prednisone, be sure to speak with your health care team and be aware of possible side effects. Overall, experts seem to agree that you should continue taking your IBD medications because active bowel inflammation poses a greater risk for infection by COVID-19 than do these medications.(4)

For more information and to keep up with the latest research from the SECURE-IBD database, you can reference their website

Takeaways

To limit susceptibility to COVID-19, it is important to keep your UC or CD symptoms under control during this time. Extra attention to nutrition can support not only our IBD but also our immune system overall. As many Americans wait to receive the vaccine, we can continue to practice good hygiene, social distancing, and mask-wearing to limit the risk of exposure to COVID-19.

For more information on IBD & COVID-19, check out the following sources:

IBD & Coronavirus from CCFA

https://www.crohnscolitisfoundation.org/coronavirus/what-ibd-patients-should-know

IBD Patient Guidance from John Hopkins

https://www.hopkinsmedicine.org/inflammatory_bowel_disease_center/covid-19-guidance.html

References 

  1. Crohn’s & Colitis Foundation. What IBD patients need to know about COVID-19. (2020).
  2. Neurath, M. F. COVID-19 and immunomodulation in IBD. Gut 69, 1335–1342 (2020).
  3. Brenner, E. J. et al. Corticosteroids, But Not TNF Antagonists, Are Associated With Adverse COVID-19 Outcomes in Patients With Inflammatory Bowel Diseases: Results From an International Registry. Gastroenterology 159, 481-491.e3 (2020).
  4. Kelly, R. IBD Patient Guidance: COVID-19. https://www.hopkinsmedicine.org/inflammatory_bowel_disease_center/covid-19-guidance.html.

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