Protection of 318 Inflammatory Bowel Disease Patients from the Outbreak and Rapid Spread of COVID-19 Infection in Wuhan, China

An, Ping; Ji, Mengyao; Ren, Haixia; Su, Juan; Kang, Jian; Yin, Anning; Zhou, Qian; Shen, Longjiao; Zhao, Liang; Jiang, Xiaoda; Xiao, Yong; Tan, Wei; Lv, Xiaoguang; Li, Jiao; Liu, Shuzhong; Zhou, Jing; Chen, Hongbin; Xu, Yanyi; Liu, Jun; Chen, Ming-Kai; Cao, Jun; Zhou, Zhongyin; Shen, Lei; Sheng, T. T.; Yu, Honggang; Dong, Weiguo; Ding, Yijuan

doi:10.2139/ssrn.3543590

Cited by 50 publications

(46 citation statements)

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“…In contrast, a recent study from Wuhan studied 318 patients with IBD (204 UC and 114 CD) during the local outbreak of the disease and did not report any covid-19 cases. 43 The reasons for this observation are not entirely clear but might relate to the local adjustment of protective measures to prevent infection, the particular awareness of the IBD patient cohort to hygiene and infection prevention and the modulation of immunosuppressive therapy (eg, stop of treatment with immunomodulators and biologicals). Alternatively, patients with IBD might be less susceptible to covid-19 and further studies in this regard are highly warranted.…”

Section: Covid-19 and Ibdmentioning

confidence: 99%

COVID-19 and immunomodulation in IBD

Neurath

2020

Gut

262

310

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The current coronavirus pandemic is an ongoing global health crisis due to COVID-19, caused by severe acute respiratory syndrome coronavirus 2. Although COVID-19 leads to little or mild flu-like symptoms in the majority of affected patients, the disease may cause severe, frequently lethal complications such as progressive pneumonia, acute respiratory distress syndrome and organ failure driven by hyperinflammation and a cytokine storm syndrome. This situation causes various major challenges for gastroenterology. In the context of IBD, several key questions arise. For instance, it is an important question to understand whether patients with IBD (eg, due to intestinal ACE2 expression) might be particularly susceptible to COVID-19 and the cytokine release syndrome associated with lung injury and fatal outcomes. Another highly relevant question is how to deal with immunosuppression and immunomodulation during the current pandemic in patients with IBD and whether immunosuppression affects the progress of COVID-19. Here, the current understanding of the pathophysiology of COVID-19 is reviewed with special reference to immune cell activation. Moreover, the potential implications of these new insights for immunomodulation and biological therapy in IBD are discussed.

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Section: Covid-19 and Ibdmentioning

confidence: 99%

COVID-19 and immunomodulation in IBD

Neurath

2020

Gut

262

310

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“…A pragmatic approach to identify individuals within the highest risk group has been adopted: may have protected them from infection, with none of them reporting infection, as of 28 February 2020. 17 At the time of writing, there is a lot of activity at UK government level around the wearing of masks by the general population in public spaces and hospitals. The BSG recommends members of the public to follow the most up to date advice from the government with respect to this.…”

Section: Covid-19 Disease and Ibdmentioning

confidence: 99%

British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic

Kennedy

Jones

Lamb

et al. 2020

Gut

241

282

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The COVID-19 pandemic is putting unprecedented pressures on healthcare systems globally. Early insights have been made possible by rapid sharing of data from China and Italy. In the UK, we have rapidly mobilised inflammatory bowel disease (IBD) centres in order that preparations can be made to protect our patients and the clinical services they rely on. This is a novel coronavirus; much is unknown as to how it will affect people with IBD. We also lack information about the impact of different immunosuppressive medications. To address this uncertainty, the British Society of Gastroenterology (BSG) COVID-19 IBD Working Group has used the best available data and expert opinion to generate a risk grid that groups patients into highest, moderate and lowest risk categories. This grid allows patients to be instructed to follow the UK government’s advice for shielding, stringent and standard advice regarding social distancing, respectively. Further considerations are given to service provision, medical and surgical therapy, endoscopy, imaging and clinical trials.

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“…Likewise, patients with inflammatory bowel disease (IBD) using biologics and immunosuppressive agents are at increased risk for more frequent and severe infections and could be more susceptible to SARS-CoV-2 infection [48]. Fortunately, with early precautions for COVID-19 prevention and control, not a single patient of the 318 patients (204 with ulcerative colitis and 114 with Crohn's disease) in the IBD registry in Wuhan, has been reported to be infected with SARS-CoV-2 [54]. These precautions included recommendations on the use of immunosuppressive agents and biologics, diet, and intentional postponement of elective surgery and endoscopy, as well as personal protection provisions [55].…”

Section: Covid-19 and Pre-existing Digestive Diseasesmentioning

confidence: 99%