Adalimumab, an anti-Tumor Necrosis Factor alpha (TNFα) antibody, may be effective in the managing inflammatory bowel disease symptoms in patients with COVID-19, according to a case study published in the Journal of Crohn’s and Colitis. Because patients with IBD frequently undergo immunosuppressive therapies, infections like COVID-19 can pose as serious risks.
Entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into human cells is coupled to TNFα production. Accordingly, authors hypothesized that an anti-TNFα antibody, adalimumab, may be used in patients with IBD without posing a significant risk of IBD recurrence.
Study authors focused on a 30-year-old male with COVID-19 and ileal Crohn’s disease (CD) in remission after treatment with adalimumab. The patient developed mild pneumonia, had a fast resolution of symptoms, and was discharged from the hospital quickly. He did not have diarrhea, and fecal calprotein was at a normal level. Likewise, the patient was noted as showing no signs of CD recurrence during his hospital stay for COVID-19 treatment. After 5 days, the patient showed no signs of pulmonary infiltrate of SARS-CoV-2.
The authors concluded that that adalimumab may be useful in maintaining IBD remission during COVID-19 treatment, and it may be a useful tool in managing and preventing COVID-driven pneumonia. However, they also note that future studies should be conducted in order to evaluate the risk of COVID-19 in patients with IBD according to age and comorbidities.
Tursi A, Papa A. Impact of anti-tnfα antibodies on the risk of COVID-19 and its severity in patients with inflammatory bowel diseases (published online April 18, 2020). J Crohns Colitis. doi: 10.1093/ecco-jcc/jjaa076.