Are Patients with Inflammatory Bowel Diseases More Susceptible to COVID-19?

Inflammatory bowel diseases are known to be associated with changes in the body’s defense.

Patients with inflammatory bowel disease (IBD) do not have increased risk of acquiring coronavirus disease 2019 (COVID-19), and patients who acquire the infection develop less severe symptoms, according to results of a study published in Clinical Gastroenterology and Hepatology.

Evidence suggests that poor clinical outcomes are more common among patients who have existing comorbidities in conjunction with COVID-19. Likewise, physicians and patients have expressed uncertainty and concern regarding the use of biologic and immunosuppressant agents in treating IBD. To examine the potential association of IBD treatment and COVID-19 risk, researchers studied a cohort of 6000 patients with IBD located in areas with a high incidence of COVID-19 from Nancy University Hospital, France (n=2000) and Humanitas, Milan, Italy (n=4000). COVID-19 was diagnosed in patients from these groups using polymerase chain reaction of nasopharyngeal swab samples. Cases were identified during routine telemedicine and infusion center visits.

Of the 6000 patients, 15 tested positive for COVID-19, the majority of whom were women. Only 5 of the 15 patients with confirmed cases of COVID-19 were hospitalized, and none of them required intensive care. The cumulative incidence of infection among the patient population was 0.0025, compared to the 0.0017 incidence in the general population. Further, there were no instances of mortality among the cohort of patients in the present investigation, though cumulative mortality rate and need for intensive support in the general population of both regions were 13% and 6% respectively.

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Researchers noted, “A key feature of COVID-19 related acute respiratory syndrome is the activation of the immune system characterized by a cytokines storm.” Investigators believe that the use of potent anti-inflammatory drugs may provide protection for patients with IBD because drugs such as anti-tumor necrosis factor therapy have been associated with lower risk of acquiring opportunistic viral infections. 

Disclosure: Study authors disclosed financial relationships with the pharmaceutical industry. For a full list of disclosures, please refer to the original study.

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Allocca M, Fiorino G, Zallot C, et al. Incidence and patterns of COVID-19 among inflammatory bowel disease patients from the Nancy and Milan cohorts. [published online April 26, 2020]. Clin Gastroenterol Hepatol.