Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Extract

Coronavirus disease 2019 (COVID-19) disease, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), reached a WHO pandemic level in the early 2020, universally dominating activities of health systems thereafter, until the “public health emergency of international concern” status was terminated by May 2023. Expectedly, services to people with Inflammatory Bowel Disease (IBD) were significantly affected, also, as several changes had to be implemented to patient monitoring and treatment.1 At that time, a central concern had been that treatment with either nonspecific [steroids, thiopurines, methotrexate] or targeted [biologics and small molecules] immunomodulators may inflict greater risk for acquiring or having a more severe course of infection with SARS-CoV-2. As data gradually accumulated, however, it became obvious that patients with IBD did not appear to have increased risk for adverse outcomes (hospitalization, intensive care unit admission, death) in comparison to the general population.2

To address the apparent paradox of favorable outcomes of COVID-19 in the presence of immunosuppression, Pisani et al. propose that patients with IBD may be protected from severe forms of COVID-19 through a combination of compromised viral entry into the intestinal epithelium and enhanced innate anti-viral responses.3 The authors tested their hypothesis in a large cohort of patients with ulcerative colitis (UC) and Crohn's disease (CD) from the region of Lombardy in Italy. The majority of patients was receiving immunomodulatory therapies and most of them had disease in remission or with mild activity. The authors evaluated the seroprevalence of anti-SARS-CoV-2 antibodies in the patient group and plotted it against publicly available regional data on verified COVID-19 cases. Their analysis confirmed reduced infection rates among individuals with IBD, thus, corroborating previous data across IBD populations of different ethnic and geographical backgrounds.2 Further studies have also shown that COVID-19 runs a benign course in the majority of infected IBD patients,4 while others have even proposed a protective effect of treatment with certain biologics for patients with CD or UC.5 This can be attributed to less exposure of IBD patients due to stricter adherence to protective measures or minimal interaction with the health system as a result of effective therapy. Alternatively, biological agents may be beneficial per se, through modification of COVID-driven inflammatory pathways.5 Overall, the bulk of evidence supports the conclusion that patients with IBD are not a high-risk population for COVID disease and justify societies’ guidelines for and clinical practices of uninterrupted treatment during the pandemic.6

Subject
Genetics
Issue Section:
INVITED EDITORIAL
You do not currently have access to this article.
Download all slides