The complex relationship between viruses and inflammatory bowel disease – review and practical advices for the daily clinical decision-making during the SARS-CoV-2 pandemic

Abstract

The coronavirus disease 2019 (COVID-19) outbreak emerged in December 2019 in China and rapidly spread worldwide. Inflammatory bowel disease (IBD) patients are likely to be more susceptible to viral infections, and this is significantly influenced by the type of therapy they receive. Thus, issues specifically concerning the medical treatment of IBD patients were shortly addressed at the beginning of the pandemic. However, recently available data on the occurrence and outcome of SARS-CoV-2 infection in IBD patients does not address the concerns raised at the beginning of the pandemic. Growing evidence and the rapid changes happening over the past few weeks have helped elucidate the current situation, contribute to our understanding of the disease, and many previously raised questions could now be answered. We hereby summarise available evidence regarding viral infections and IBD, focusing on SARS-CoV infections, and we provide practical recommendations related to patient management during the COVID-19 pandemic era.

Short-Term Clinical Response and Changes in the Fecal Microbiota and Metabolite Levels in Patients with Crohn’s Disease After Stem Cell Infusions

“… 4 An infection or environmental factor may trigger or aggravate the disease. 5 CD is treated with corticosteroids (CSs), immunomodulatory agents, and “biologic therapies,” including anti-TNF-α antibodies, vedolizumab, and ustekinumab. 6-9 The standard anti-inflammatory regimen, however, does not halt disease progression.…”

Inflammatory Bowel Disease Management during the COVID-19 Pandemic: A Literature Review

“…9,10 IBD-related cytokines, such as IFN-gamma (interferon gamma), may boost ACE2 expression through cytokine signaling that drives ACE2 promoter activity, supporting the idea that mucosal inflammation may enhance ACE2 expression. 9,11 CD and ulcerative colitis are two forms of IBD, which is a prevalent immune-mediated inflammatory illness with a high worldwide frequency. 12 Predisposing factors for IBD are genetics, microorganisms, cigarette smoking, appendectomy, lack of personal hygiene, overuse of anti-inflammatory drugs and antibiotics, vitamin D deficiency, diets, stress, and poor lifestyle.…”