COVID-19 and Inflammatory Bowel Diseases: Risk Assessment, Shared Molecular Pathways, and Therapeutic Challenges

Abstract

<jats:p><jats:italic>Background</jats:italic>. The novel coronavirus SARS-CoV-2 causing COVID-19 disease is yielding a global outbreak with severe threats to public health. In this paper, we aimed at reviewing the current knowledge about COVID-19 infectious risk status in inflammatory bowel disease (IBD) patients requiring immunosuppressive medication. We also focused on several molecular insights that could explain why IBD patients appear not to have higher risks of infection and worse outcomes in COVID-19 than the general population in an attempt to provide scientific support for safer decisions in IBD patient care. <jats:italic>Methods</jats:italic>. PubMed electronic database was interrogated for relevant articles involving data about common molecular pathways and shared treatment strategies between SARS-CoV-2, SARS-CoV-1, MERS-CoV, and inflammatory bowel diseases. Besides, Neural Covidex, an artificial intelligence tool, was used to answer queries about pathogenic coronaviruses and possible IBD interactions using the COVID-19 Open Research Dataset (CORD-19). <jats:italic>Discussions</jats:italic>. Few molecular and therapeutic interactions between IBD and pathogenic coronaviruses were explored. First, we showed how the activity of soluble angiotensin-converting enzyme 2, CD209L other receptors, and phosphorylated <jats:italic>α</jats:italic> subunit of eukaryotic translation initiation factor 2 might exert protective impact in IBD in case of coronavirus infection. Second, IBD medication was discussed in the context of possible beneficial effects on COVID-19 pathogeny, including “cytokine storm” prevention and treatment, immunomodulation, interferon signaling blocking, and viral endocytosis inhibition. <jats:italic>Conclusions</jats:italic>. Using the current understanding of SARS-CoV-2 as well as other pathogenic coronaviruses immunopathology, we showed why IBD patients should not be considered at an increased risk of infection or more severe outcomes. Whether our findings are entirely applicable to the pathogenesis, disease susceptibility, and treatment management of SARS-CoV-2 infection in IBD must be further explored.</jats:p>

The Frequency Of SARS-Cov-2 Infection and The Impact Of COVID-19 Vaccination on The Disease Morbidity in Polish Pediatric Patients with Inflammatory Bowel Disease Treated with Biologic Therapies

“…A potential risk groups that has required special attention during the pandemic were chronic diseases, particularly the ones with impaired immune system such as inflammatory bowel diseases (IBD). Not only altered immune response that plays a key role in the pathogenesis of IBD, but also the vast majority of drugs modulating immune system function, made IBD patients a highrisk group for SARS-CoV-2 infection and severe course of this disease [2]. However, current data do not demonstrate increased risk of infection or its severity in patients with IBD in comparison to the general population, except for those on corticosteroid therapy [3].…”

Seroprevalence of Anti-Sars-CoV-2 Antibodies in Patients with Inflammatory Bowel Disease

“…This infectious disease represents a key challenge for gastroenterologists and patients with in ammatory bowel disease (IBD), a potential risk group that has required special attention during the pandemic. Given that altered immune response plays a key role in the pathogenesis of IBD and that the vast majority of drugs used modulate immune system function, IBD patients were considered to be at high risk for SARS-CoV-2 infection and severe disease [2]. However, current data do not appear to demonstrate increased risk of infection or severity in patients with IBD relative to the general population, except for those on corticosteroid therapy (3).…”

Seroprevalence of ANTI-SARS-CoV-2 antibodies in patients with inflammatory bowel disease

“…This infectious disease represents a key challenge for gastroenterologists and patients with inflammatory bowel disease (IBD), a potential risk group that has required special attention during the pandemic. Given that altered immune response plays a key role in the pathogenesis of IBD and that the vast majority of drugs used modulate immune system function, IBD patients were considered to be at high risk for SARS-CoV-2 infection and severe disease 2 . However, current data do not appear to demonstrate increased risk of infection or severity in patients with IBD relative to the general population, except for those on corticosteroid therapy 3 .…”