Clinical assessment of risk factors for infection in inflammatory bowel disease patients

Tosca, Joan; García, N Álvarez; Pascual, Isabel; Bosca-Watts, Marta Maia; Antón, Rosario; Sanahuja, Ana; Más, P.; Mora, Francisco; Mínguez, Miguel

doi:10.1007/s00384-019-03501-0

Cited by 8 publications

(16 citation statements)

References 36 publications

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“…For lower respiratory tract infections with seasonal (non‐COVID‐19) coronavirus, risk factors in other immunocompromised patient groups have included age >50 years, receipt of corticosteroids, lymphopenia and neutropenia 26,40 . For IBD patients, the greatest risk factor for general immunosuppression and infections remains pharmacological 41,42 . Nutritional status, co‐morbidities, age and disease activity also contribute 42,43 .…”

Section: Sars‐cov‐2 Virus and Covid‐19mentioning

confidence: 99%

Review article: prevention, diagnosis and management of COVID‐19 in the IBD patient

Al‐Ani

Prentice

Rentsch

et al. 2020

Aliment Pharmacol Ther

110

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Summary Background The current COVID‐19 pandemic, caused by SARS‐CoV‐2, has emerged as a public health emergency. All nations are seriously challenged as the virus spreads rapidly across the globe with no regard for borders. The primary management of IBD involves treating uncontrolled inflammation with most patients requiring immune‐based therapies. However, these therapies may weaken the immune system and potentially place IBD patients at increased risk of infections and infectious complications including those from COVID‐19. Aim To summarise the scale of the COVID‐19 pandemic, review unique concerns regarding IBD management and infection risk during the pandemic and assess COVID‐19 management options and drug interactions in the IBD population. Methods A literature review on IBD, SARS‐CoV‐2 and COVID‐19 was undertaken and relevant literature was summarised and critically examined. Results IBD patients do not appear to be more susceptible to SARS‐CoV‐2 infection and there is no evidence of an association between IBD therapies and increased risk of COVID‐19. IBD medication adherence should be encouraged to prevent disease flare but where possible high‐dose systemic corticosteroids should be avoided. Patients should exercise social distancing, optimise co‐morbidities and be up to date with influenza and pneumococcal vaccines. If a patient develops COVID‐19, immune suppressing medications should be withheld until infection resolution and if trial medications for COVID‐19 are being considered, potential drug interactions should be checked. Conclusions IBD patient management presents a challenge in the current COVID‐19 pandemic. The primary focus should remain on keeping bowel inflammation controlled and encouraging medication adherence.

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Section: Sars‐cov‐2 Virus and Covid‐19mentioning

confidence: 99%

Review article: prevention, diagnosis and management of COVID‐19 in the IBD patient

Al‐Ani

Prentice

Rentsch

et al. 2020

Aliment Pharmacol Ther

110

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“…33 of these individuals had direct patient contact in the workplace. After the wearing of masks was made obligatory, epidemiological infection tracking detected no further cases of nosocomial person-to-person (employee/patient) transmission [57].…”

Section: Recommendation 13mentioning

confidence: 99%

Addendum to S3-Guidelines Crohn’s disease and ulcerative colitis: Management of Patients with Inflammatory Bowel Disease in the COVID-19 Pandemic – open questions and answers

et al. 2020

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The COVID-19 pandemic is a global outbreak of new onset infections with the SARS-CoV-2 virus. To date, more than 3.4 million people have been infected throughout the world. In Germany, approximately 450,000 patients suffer from inflammatory bowel disease; these patients generally require continuous expert care and support. Against the background of a rapidly accumulating knowledge base on SARS-CoV-2, 68 expert authors of the current DGVS guidelines for Crohn’s disease and ulcerative colitis took part in a virtual meeting to compile up-to-date, practice-orientated recommendations aimed at improving the care of patients with IBD. These recommendations address the risk of infection, including the risk for specific patient groups, the possible course of the disease, and consequences for pharmacological and surgical therapies of the underlying disease, as well as general measures for infection prevention and adjuvant prophylactic and therapeutic options.

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“…einen schweren Verlauf durch die Medikation beeinflusst („Therapie als Risikofaktor“). Dennoch sind auch die Krankheitsaktivität (OR: 3,35; 95 %-KI: 1,23–9,23) 45 und eine Malnutrition (OR: 6,26; 95 %-KI: 1,20–32,78) 56 57 signifikante nichtpharmakologische Risikofaktoren. In einer kleineren Observationsstudie aus Italien unter Einschluss von 79 Patienten mit CED und COVID-19-Erkrankung zeigte sich, dass das Alter über 65 Jahre und die Krankheitsaktivität mit der Entwicklung einer schweren COVID-19-Pneumonie bzw.…”

Section: Kapitel 1: Risiko Für Eine Covid-19-erkrankung Bei Patientenunclassified

“…Davon waren 33 Personen in einem Bereich mit direktem Patientenkontakt eingesetzt. Nach Einführung der Pflicht, einen Mund-Nasen-Schutz zu tragen, konnte in der infektionsepidemiologischen Nachverfolgung keine nosokomiale Person-zu-Person(Mitarbeiter/Patienten)-Übertragung mehr festgestellt werden[57].…”

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Addendum zu den S3-Leitlinien Morbus Crohn und Colitis ulcerosa: Betreuung von Patienten mit chronisch entzündlichen Darmerkrankungen in der COVID-19-Pandemie – offene Fragen und Antworten

et al. 2020

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ZusammenfassungDie COVID-19-Pandemie ist ein weltweiter Ausbruch von neu aufgetretenen Infektionen mit dem SARS-CoV-2-Virus, von denen weltweit derzeit mehr als 10.670.000 Menschen erkrankt sind bzw. waren. In Deutschland leiden ca. 450.000 Patienten an einer chronisch entzündlichen Darmerkrankung; diese Patienten benötigen in der Regel eine kontinuierliche und kompetente Betreuung. Vor dem Hintergrund eines rasch zunehmenden Wissenszuwachses haben 68 Experten, die die derzeit gültigen Leitlinien der DGVS zum Morbus Crohn und zur Colitis ulcerosa erstellt haben, im Rahmen einer virtuellen Konferenz aktuelle und praxisnahe Empfehlungen formuliert, um die Versorgung von CED-Patienten zu verbessern. Diese adressieren das Infektionsrisiko einschließlich des Risikos für besondere Gruppen, den möglichen Verlauf der Erkrankung und die Konsequenzen für die medikamentöse und die operative Therapie der Grunderkrankung sowie allgemeine Maßnahmen zur Infektionsprävention und adjuvante Präventions- und Therapiemöglichkeiten.

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Clinical assessment of risk factors for infection in inflammatory bowel disease patients

Cited by 8 publications

References 36 publications

Review article: prevention, diagnosis and management of COVID‐19 in the IBD patient

Review article: prevention, diagnosis and management of COVID‐19 in the IBD patient

Addendum to S3-Guidelines Crohn’s disease and ulcerative colitis: Management of Patients with Inflammatory Bowel Disease in the COVID-19 Pandemic – open questions and answers

Addendum zu den S3-Leitlinien Morbus Crohn und Colitis ulcerosa: Betreuung von Patienten mit chronisch entzündlichen Darmerkrankungen in der COVID-19-Pandemie – offene Fragen und Antworten

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