Practical management of inflammatory bowel disease patients during the <scp>COVID</scp>‐19 pandemic: expert commentary from the Gastroenterological Society of Australia <scp>Inflammatory Bowel Disease</scp> faculty

To date, there are limited data regarding IBD and COVID-19, but evidence with a higher quality has been gradually accumulated recently. We aimed to review the management of IBD in the COVID-19 era. RISK OF COVID-19 IN IBD PATIENTSIn addition to fever and respiratory symptoms, 8 about 15% of COVID-19 patients complain of gastrointestinal symptoms such as diarrhea, nausea, vomiting, and anorexia, with variable frequencies. 9 These symptoms are more likely to be noted in patients with severe This could be associated with the expression of angiotensin conversion enzyme 2 (ACE2) and transmembrane protease serine protease 2 (TMPRSS2) in the enterocytes, which play an important role in the entrance of viruses into human cells and the regulation of the binding to the receptors. 11,12 Interestingly, ACE2 and TMPRSS2 were

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“…55 Because nutrition is also an emerging prognostic factor, early intervention and support are warranted. 56…”

Section: General Management For Ibd In Covid-19 Pandemicmentioning

confidence: 99%

Management of inflammatory bowel disease in the COVID-19 era

Kim

Jang

2022

Intest Res

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“…Major American gastroenterological societies have recommended postponing non‐emergency endoscopies and using personal protective equipment in emergency endoscopies 199‐201 . For IBD patients, it is recommended that immunosuppressive drugs be delayed until the symptoms of COVID‐19 have resolved; however, the recommended management for severe GI diseases is mainly focused on prevention and supportive measures (64, 202 ).…”

Section: Management Of Sars‐cov‐2 Patients With Gi Manifestationsmentioning

confidence: 99%

Gastrointestinal and renal complications in SARS‐CoV‐2‐infected patients: Role of immune system

et al. 2020

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The recent severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) disease has been accompanied by various gastrointestinal (GI) and renal manifestations in significant portion of infected patients. Beside studies on the respiratory complications of coronavirus infection, understanding the essential immunological processes underlying the different clinical manifestations of virus infection is crucial for the identification and development of effective therapies. In addition to the respiratory tract, the digestive and urinary systems are the major sources of virus transmission. Thus, knowledge about the invasion mechanisms of SARS‐CoV‐2 in these systems and the immune system responses is important for implementing the infection prevention strategies. This article presents an overview of the gut and renal complications in SARS‐CoV‐2 infection. We focus on how SARS‐CoV‐2 interacts with the immune system and the consequent contribution of immune system, gut, and renal dysfunctions in the development of disease.

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“…Al-Ani et al carried out a literature review to prescribe that IBD patients should desist from immune-suppressing medications until infection resolution 7 . Aysha et al reported that a sub‐group of IBD patients with mild COVID-19 disease initially presented with diarrhoea rather than respiratory symptoms, leading to delayed diagnosis 8 , while D’Amico also reported that diarrhoea is a common symptom of COVID-19 in IBD patients 9 . Neurath et al posed a question on the role of immunosuppression and immunomodulation on the COVID-19 outcome of IBD patients 10 .…”

Section: Introductionmentioning

confidence: 99%

A machine learning approach identifies 5-ASA and ulcerative colitis as being linked with higher COVID-19 mortality in patients with IBD

Roy

Sheikh

Furey

2021

Sci Rep

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Inflammatory bowel diseases (IBD), namely Crohn’s disease (CD) and ulcerative colitis (UC) are chronic inflammation within the gastrointestinal tract. IBD patient conditions and treatments, such as with immunosuppressants, may result in a higher risk of viral and bacterial infection and more severe outcomes of infections. The effect of the clinical and demographic factors on the prognosis of COVID-19 among IBD patients is still a significant area of investigation. The lack of available data on a large set of COVID-19 infected IBD patients has hindered progress. To circumvent this lack of large patient data, we present a random sampling approach to generate clinical COVID-19 outcomes (outpatient management, hospitalized and recovered, and hospitalized and deceased) on 20,000 IBD patients modeled on reported summary statistics obtained from the Surveillance Epidemiology of Coronavirus Under Research Exclusion (SECURE-IBD), an international database to monitor and report on outcomes of COVID-19 occurring in IBD patients. We apply machine learning approaches to perform a comprehensive analysis of the primary and secondary covariates to predict COVID-19 outcome in IBD patients. Our analysis reveals that age, medication usage and the number of comorbidities are the primary covariates, while IBD severity, smoking history, gender and IBD subtype (CD or UC) are key secondary features. In particular, elderly male patients with ulcerative colitis, several preexisting conditions, and who smoke comprise a highly vulnerable IBD population. Moreover, treatment with 5-ASAs (sulfasalazine/mesalamine) shows a high association with COVID-19/IBD mortality. Supervised machine learning that considers age, number of comorbidities and medication usage can predict COVID-19/IBD outcomes with approximately 70% accuracy. We explore the challenge of drawing demographic inferences from existing COVID-19/IBD data. Overall, there are fewer IBD case reports from US states with poor health ranking hindering these analyses. Generation of patient characteristics based on known summary statistics allows for increased power to detect IBD factors leading to variable COVID-19 outcomes. There is under-reporting of COVID-19 in IBD patients from US states with poor health ranking, underpinning the perils of using the repository to derive demographic information.

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Practical management of inflammatory bowel disease patients during the COVID‐19 pandemic: expert commentary from the Gastroenterological Society of Australia Inflammatory Bowel Disease faculty

Cited by 14 publications

References 21 publications

Management of inflammatory bowel disease in the COVID-19 era

Management of inflammatory bowel disease in the COVID-19 era

Gastrointestinal and renal complications in SARS‐CoV‐2‐infected patients: Role of immune system

A machine learning approach identifies 5-ASA and ulcerative colitis as being linked with higher COVID-19 mortality in patients with IBD

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