COVID-19 infection in Crohn’s disease under treatment with adalimumab

Tursi, Antonio; Angarano, Gioacchino; Monno, Laura; Saracino, Annalisa; Signorile, F.; Ricciardi, Aurelia; Papa, Alfredo

doi:10.1136/gutjnl-2020-321240

Cited by 47 publications

(30 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Mazza S et al, described a case of Covid-19 pneumonia occurring in an 80-year-old female with acute severe ulcerative colitis [20] ; the patient died despite treatment with systemic steroids plus non-invasive ventilation, and a combination of lopinavir/ritonavir and hydroxychloroquine. Another case report from Italy described a 30-year old male with Crohn's disease and Covid-19, whose pulmonary disease recovered quickly despite the patient was under treatment with adalimumab [21] . Another paper described a man in his late 60 s embarked on the Diamond Princess cruise ship who had been treated with infliximab and azathioprine for ulcerative colitis [22] .…”

Section: Resultsmentioning

confidence: 99%

“…Among the 87 records that were identified through electronic search after duplicates removal, both reviewers independently evaluated the titles and abstracts, removed 68 studies that did not meet the inclusion criteria, and selected 19 potentially relevant reports that were identified and retrieved for detailed evaluation. Among these, 18 papers [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] were included in the qualitative synthesis ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 in patients with inflammatory bowel disease: A systematic review of clinical data

Macaluso

Orlando

2020

Digestive and Liver Disease

View full text Add to dashboard Cite

Background Great efforts by the scientific community are rapidly expanding the evidence on the clinical interplay between Covid-19 and inflammatory bowel disease (IBD). Aims We performed a systematic review of the literature on published Covid-19 cases occurring in patients with IBD. Methods PubMed Central/Medline and Embase were systemically searched for records up to May 31, 2020. Results 13 cohort studies and 5 single case reports were included in the qualitative synthesis. A cumulative number of approximately 800 patients with IBD and Covid-19 were identified. The case fatality rate ranged from 0% to 20.0%. Overall, immunomodulators and biologics were not associated with higher risk of Covid-19 or with negative outcomes, while the use of systemic corticosteroids was related to worse prognosis in some studies. Conclusions This systematic review highlighted two main points that may help clinicians dealing with IBD in reassuring their patients: (1) patients with IBD do not seem to be at higher risk of being infected by SARS-COV-2 than the general population; (2) in case of Covid-19, treatment with immunomodulators or biologics is not associated with worse prognosis, while systemic steroids are suspected to be potentially detrimental, even if more data are needed to confirm this point.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

COVID-19 in patients with inflammatory bowel disease: A systematic review of clinical data

Macaluso

Orlando

2020

Digestive and Liver Disease

View full text Add to dashboard Cite

show abstract

“…The first published report described the case of a 30-year-old Crohn’s disease patient in long-term clinical remission under adalimumab therapy who developed fever and chest pain, diagnosed as COVID-19. The patient only needed oxygen support upon hospitalization and the symptoms resolved within 24 h [16]. A recently published prospective case series of 86 immune-mediated inflammatory disease patients who were receiving immunomodulatory therapies indicated that the incidence of COVID-19 hospitalization was consistent with that of patients in the general population of New York City.…”

Section: Discussionmentioning

confidence: 99%

Mild COVID-19 Symptoms in an Infliximab-Treated Ulcerative Colitis Patient: Can Ongoing Anti-TNF Therapy Protect against the Viral Hyperinflammatory Response and Avoid Aggravated Outcomes?

Abdullah

Atreya

2020

Visc Med

View full text Add to dashboard Cite

The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, represents a potentially major challenge to patients with immune-mediated inflammatory diseases who are treated with immunomodulatory therapies. We report the case of an 18-year-old ulcerative colitis patient in sustained clinical remission who 4 days after application of her ongoing therapy with the anti-TNF antibody infliximab developed mild respiratory and abdominal symptoms. The patient was subsequently diagnosed with COVID-19 but did not need hospitalization. The clinical symptoms completely resolved within 1 week after onset and there was no change in ulcerative colitis activity. The recently applied anti-TNF therapy did not lead to exacerbation of the infectious symptoms. Current recommendations strongly favor continuation of effective maintenance anti-TNF therapy in inflammatory bowel disease patients, as there is no evidence for aggravated CO-VID-19 upon infection. It is unclear whether anti-TNF treatment might even have assisted in preventing worsening of COVID-19 and improving outcome. Further data in the group of immune-mediated inflammatory disease patients under anti-TNF therapy are urgently needed.

show abstract

“…A retrospective study from the United States including a large cohort of IBD patients reported that the incidence rate of COVID-19 per 1000 IBD patients was of 0.61 in patients treated with anti-TNF-α and 1 in those not in treatment with anti-TNF-α ( p = 0.618). 16 Interestingly, a recent case report 17 and larger studies 18 , 19 hypothesized that anti-TNF-α antibodies could guarantee a milder course of COVID-19. In fact, in the SECURE-IBD database (>1500 patients enrolled), as of 16 June 2020, 16% of patients treated with anti-TNF-α agents required hospitalization, and only 2% experienced unfavorable outcomes, defined as intensive care unit admission, ventilator use, or death.…”

Section: The Decaloguementioning

confidence: 99%

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Papa

Lopetuso

et al. 2020

Therap Adv Gastroenterol

Self Cite

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised several concerns for patients with chronic immune-mediated diseases, including inflammatory bowel disease (IBD). As the outbreak appears to be in the descending phase, at least in some part of the world, as in most European countries, guidance is urgently needed to provide optimal care for our IBD patients in order to gradually and safely reduce the gap in care that has been accumulated in the months of lockdown and to face all the backlogs. Therefore, we have provided a decalogue of practical recommendations for gastroenterologists to manage patients with IBD in the post-peak phase of the COVID-19 pandemic. They include all the aspects of IBD care, not only pharmacological ones but also endoscopy, surgery, psychological treatment, telemedicine, diagnostics and educational tasks provided by doctors and patient associations.

show abstract

COVID-19 infection in Crohn’s disease under treatment with adalimumab

Cited by 47 publications

References 7 publications

COVID-19 in patients with inflammatory bowel disease: A systematic review of clinical data

COVID-19 in patients with inflammatory bowel disease: A systematic review of clinical data

Mild COVID-19 Symptoms in an Infliximab-Treated Ulcerative Colitis Patient: Can Ongoing Anti-TNF Therapy Protect against the Viral Hyperinflammatory Response and Avoid Aggravated Outcomes?

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Contact Info

Product

Resources

About