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Inflammatory bowel disease amid the COVID-19 pandemic: impact, management strategies, and lessons learned
Mahesh Gajendran1, Abhilash Perisetti2, Muhammad Aziz3
1Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, TX (Mahesh Gajendran).
Insights
The COVID-19 pandemic impacts inflammatory bowel disease (IBD) patients, many on immunosuppressants. Experts advise continuing IBD medications and consulting physicians for symptom management to mitigate risks.
Area of Science:
- Immunology
- Gastroenterology
- Infectious Diseases
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, has a global reach, affecting numerous countries.
- Patients with severe COVID-19 often present with comorbidities like hypertension, diabetes, and cardiovascular disease.
- Inflammatory Bowel Disease (IBD) affects millions worldwide, with many patients requiring immunosuppressant therapy, raising concerns about their susceptibility to SARS-CoV-2.
Purpose of the Study:
- To explore the impact of COVID-19 on patients with Inflammatory Bowel Disease (IBD).
- To address the unique challenges in managing IBD patients during the COVID-19 pandemic.
- To provide guidance on medication management and infection prevention for IBD patients.
Main Methods:
- Data from the Surveillance Epidemiology of Coronavirus under Research Exclusion (SECURE-IBD) registry was analyzed.
- Review of current recommendations from IBD societies and experts.
- Individualized patient management strategies were considered.
Main Results:
- Approximately 1439 IBD patients infected with SARS-CoV-2 have been reported in the SECURE-IBD registry.
- Management of IBD patients with COVID-19 presents unique challenges requiring individualized approaches.
- IBD societies strongly recommend against discontinuing IBD medications.
Conclusions:
- IBD patients are urged to consult their physician before altering IBD medication in case of COVID-19 symptoms or IBD flare-ups.
- Strict adherence to social distancing is crucial for IBD patients to minimize infection risk.
- Ongoing research and evolving understanding of COVID-19 may influence future management strategies for IBD patients.
Abstract:
The current outbreak of COVID-19 pandemic caused by SARS-CoV-2 has affected nearly 188 countries. Patients with severe COVID-19 are more commonly elderly and suffer from comorbidities such as hypertension, diabetes mellitus, coronary artery disease, chronic pulmonary disease, obesity, and cancer. Inflammatory bowel disease (IBD) affects as many as 6.8 million people globally, and a significant proportion of them are treated with immunosuppressants. Hence, there is an ongoing concern over the impact of COVID-19 on IBD patients and their susceptibility to it. So far, there are about 1439 IBD patients in the Surveillance Epidemiology of Coronavirus under Research Exclusion (SECURE-IBD) registry reported to be infected with SARS-CoV-2. There are many unique challenges and dilemmas that need to be taken into account when managing an IBD patient with COVID-19. The management of each patient should be individualized. The IBD societies and experts have strongly recommended that patients should not discontinue their IBD medications. If the patients have symptoms of COVID-19 or IBD flare-up, they are recommended to call their IBD physician first to discuss their medication. In addition, IBD patients are urged to practice social distancing strictly to minimize the chances of infection. As COVID-19 is rapidly evolving, our experience and understanding of its impact on the IBD population may potentially change in the near future.
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