Review of inflammatory bowel disease and COVID-19

Sultan, Keith; Mone, Anjali; Durbin, Laura; Khuwaja, Samreen; Swaminath, Arun

doi:10.3748/wjg.v26.i37.5534

Cited by 27 publications

(37 citation statements)

References 35 publications

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“…In IBD patients, older age in combination with comorbidities, are found to be a risk factor for severe COVID-19. A possibly higher risk for patients with UC compared to CD is also found [3,5]. Interestingly, our findings revealed that IBD patients <50 years had more concerns about medical treatment and COVID À 19 compared to those !50 years.…”

Section: Discussionmentioning

confidence: 55%

“…These patients have regular and frequent visits, thus the restrictions due to the pandemic may have the greatest personal impact and are most intrusive. It is likely that IBD patients in general and those on immunosuppressive therapy in particular would be concerned about their own health and the risk of being infected by SARS-CoV-2 and develop COVID-19 [3].…”

Section: Discussionmentioning

confidence: 99%

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Patients with inflammatory bowel disease on immunosuppressive drugs: perspectives’ on COVID-19 and health care service during the pandemic

Moum

Opheim

2021

Scandinavian Journal of Gastroenterology

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Background and aims: Patients with inflammatory bowel diseases (IBD) have experienced changes to the routine management because of the SARS-CoV-2 pandemic. The aim of this study was to examine patients with IBD's adherence to the restrictions imposed by society and the hospital, worries and concerns regarding medical treatment and clinical follow-up under the pandemic. Methods: IBD patients (!18 years) at the outpatient clinic at Oslo University Hospital were included and answered a self-report questionnaire including concerns regarding their disease, medical therapy and follow-up during SARS-CoV-2 pandemic. Results: In total, 522 IBD patients were included, 317 Crohn's disease, 205 ulcerative colitis, 386 patients <50 years. Eighteen percent were in obligatory quarantine, and more often patients <50 years compared to patients !50 years. Five patients tested positive to SARS-CoV-2. A higher proportion <50 years reported worries for their medical treatment and risk of COVID À19 disease compared to those !50 years. Forty percent avoided family, two-thirds avoided friends, and 4% cancelled their scheduled consultation at the hospital. The hospital changed physical consultation to telephone consultation for 15% of the patients. The preferred follow-up was physical consultation. A higher proportion of the patients <50 years preferred telephone consultation compared to those !50 years. Four out of five IBD patients were satisfied with the information about their IBD and COVID-19. Conclusions: SARS-CoV-2 pandemic affects the daily lives for patients with IBD. It is important to develop evidence-base guidelines in follow-up and treatment, as well as patient information about COVID-19and IBD.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Patients with inflammatory bowel disease on immunosuppressive drugs: perspectives’ on COVID-19 and health care service during the pandemic

Moum

Opheim

2021

Scandinavian Journal of Gastroenterology

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“…In the United States, the prevalence of IBD among COVID-19 patients was found to be 1.2%, and an age greater than 66-years-old was a strong independent predictor[ 48 ]. Similarly, low rates have also been reported in pediatric IBD patients in Europe, China, Canada, Israel, and South Korea[ 42 ].…”

Section: Resultsmentioning

confidence: 95%

“…During the pandemic, particular concern has been raised in populations with the highest risk, such as the elderly and patients with preexisting medical conditions, with a specific focus on inflammatory bowel disease (IBD)[ 42 ], a gastroenterological disease caused by immune dysregulation. Upregulated expression of ACE-2 in the inflamed mucosa as well as a soluble form of ACE-2 circulating in the blood of IBD patients has been found[ 43 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

COVID-19 in gastroenterology and hepatology: Lessons learned and questions to be answered

Shao

Tang

et al. 2021

WJCC

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BACKGROUND Although coronavirus disease 2019 (COVID-19) presents primarily as a lower respiratory tract infection, increasing data suggests multiorgan, including the gastrointestinal (GI) tract and liver, involvement in patients who are infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). AIM To provide a comprehensive overview of COVID-19 in gastroenterology and hepatology. METHODS Relevant studies on COVID-19 related to the study aim were undertaken through a literature search to synthesize the extracted data. RESULTS We found that digestive symptoms and liver injury are not uncommon in patients with COVID-19 and varies in different individuals. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Other atypical GI symptoms, such as loss of smell and taste and GI bleeding, have also been reported along with the evolvement of COVID-19. Liver chemistry abnormalities mainly include elevation of aspartate transferase, alanine transferase, and total bilirubin. It is postulated to be related to the binding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus to the angiotensin converting enzyme-2 receptor located on several different human cells. CONCLUSION Standardized criteria should be established for diagnosis and grading of the severity of GI symptoms in COVID-19 patients. Gastroenterology and hepatology in special populations, such as children and elderly, should be the focus of further research. Future long-term data regarding GI symptoms should not be overlooked.

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“…Despite our important findings, several limitations must be considered [ 6 ]. First, some studies also included highly suspicious cases in their COVID-19 cohort.…”

Section: Discussionmentioning

confidence: 99%

Safety of biologics in inflammatory bowel disease patients with COVID-19

Weissman

Aziz

Lee‐Smith

et al. 2021

Int J Colorectal Dis

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Background Patients with Inflammatory bowel disease (IBD) remain highly concerned that either their disease or medications—namely, biologics—may increase the risk of severe coronavirus-2019 (COVID-19). We aimed to assess the safety of biologics in Inflammatory bowel disease (IBD) patients with COVID-19. Methods We systematically reviewed multiple databases to find relevant articles reporting the effect of biologics on “severe” COVID-19 in IBD patients. Those in the form of case series (> 10 patients), case–control, and cohort studies were included. Severe COVID-19 was defined as intensive care unit (ICU) admission, mechanical ventilation, and/or mortality. Pooled analysis with multivariate regression was performed. Results A total of 12 studies with 2681 patients were included. The proportion of females was (48.3%, 95% confidence interval (CI) 47.0–49.5%). The proportion of UC patients was (44.8%, 95% CI 41.0–48.5%). Overall, in IBD patients, the need for mechanical ventilation, intensive care unit (ICU) admission, and mortality was 5.1%, 6.1%, and 4.5%, respectively. Use of biologics did not show a moderating effect on mechanical ventilation (p = 0.68), ICU admission (p = 0.27), or mortality (p = 0.20). Conclusions Our findings advocate for the continued biologic therapy in IBD patients during the COVID-19 pandemic. Nevertheless, the incidence, severity, and outcomes related to COVID-19 in IBD patients’ needs to be reassessed as data continues to emerge.

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Review of inflammatory bowel disease and COVID-19

Cited by 27 publications

References 35 publications

Patients with inflammatory bowel disease on immunosuppressive drugs: perspectives’ on COVID-19 and health care service during the pandemic

Patients with inflammatory bowel disease on immunosuppressive drugs: perspectives’ on COVID-19 and health care service during the pandemic

COVID-19 in gastroenterology and hepatology: Lessons learned and questions to be answered

Safety of biologics in inflammatory bowel disease patients with COVID-19

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