Impact of the COVID-19 outbreak and the serum prevalence of SARS-CoV-2 antibodies in patients with inflammatory bowel disease treated with biologic drugs

Bossa, Fabrizio; Carparelli, Sonia; Palmieri, Orazio; Tavano, Francesca; Panza, Anna; Pastore, M.; Marseglia, Antonio; D’Altilia, Mario; Latiano, Tiziana; Corritore, Giuseppe; Martino, Giuseppina; Nardella, Michele; Guerra, Maritza Linares; Terracciano, Fulvia; Sacco, Michele; Perri, Francesco; Andriulli, Angelo

doi:10.1016/j.dld.2020.12.120

Cited by 19 publications

(14 citation statements)

References 23 publications

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“…Another study of 82 patients with IBD and COVID-19 showed that immunosuppression was not related to severity of disease 63 . Similar results were obtained in a study of 259 patients with IBD receiving biologic agents (TNF blockers, vedolizumab, ustekinumab) 70 . Although aminosalicylates and combined immunosuppression with thiopurines and TNF blockers had been initially associated with worse outcomes in patients with IBD and COVID-19 (ref.…”

Section: Immunosuppressants and Biologics In Ibdsupporting

confidence: 83%

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

Neurath

2021

Nat Rev Gastroenterol Hepatol

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The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health crisis causing major challenges for clinical care in patients with gastrointestinal diseases. Although triggering of anti-viral immune responses is essential for clearance of infection, some patients have severe lung inflammation and multiorgan failure due to marked immune cell dysregulation and cytokine storm syndrome. Importantly, the activation of cytotoxic follicular helper T cells and a reduction of regulatory T cells have a crucial, negative prognostic role. These findings lead to the question of whether immunosuppressive and biologic therapies for gastrointestinal diseases affect the incidence or prognosis of COVID-19 and, thus, whether they should be adjusted to prevent or affect the course of the disease. In this Review, data on the use of such therapies are discussed with a primary focus on inflammatory bowel disease, autoimmune hepatitis and liver transplantation. In particular, the roles of corticosteroids, classic immunosuppressive agents (such as thiopurines and mycophenolate mofetil), small molecules (such as Janus kinase (JAK) inhibitors), and biologic agents (such as tumour necrosis factor (TNF) blockers, vedolizumab and ustekinumab) are reviewed. Finally, the use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines for the prevention of infection in patients with gastrointestinal diseases and concomitant immunosuppressive or biologic therapy will be discussed.

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Section: Immunosuppressants and Biologics In Ibdsupporting

confidence: 83%

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

Neurath

2021

Nat Rev Gastroenterol Hepatol

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“…Some authors have also reported an increased risk of severe disease among patients with ulcerative colitis (UC) 60,70,74 and in those receiving aminosalicylates, 66 but these observations need further validation in population‐based studies. No further concerns have been reported with the remaining drugs, including small molecules like tofacitinib and biologics like ustekinumab and vedolizumab 73,75–77 …”

Section: Covid‐19 In Ibdmentioning

confidence: 99%

“…No further concerns have been reported with the remaining drugs, including small molecules like tofacitinib and biologics like ustekinumab and vedolizumab . 73 , 75 , 76 , 77 …”

Section: Covid‐19 In Ibdmentioning

confidence: 99%

COVID‐19 in gastroenterology: Where are we now? Current evidence on the impact of COVID‐19 in gastroenterology

et al. 2021

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Background The COVID‐19 pandemic has created unprecedented challenges in all fields of society with social, economic, and health‐related consequences worldwide. In this context, gastroenterology patients and healthcare systems and professionals have seen their routines changed and were forced to adapt, adopting measures to minimize the risk of infection while guaranteeing continuous medical care to chronic patients. Objective At this point, it is important to evaluate the impact of the pandemic on this field to further improve the quality of the services provided in this context. Methods/Results/Conclusion We performed a literature review that summarizes the main aspects to consider in gastroenterology, during the pandemic crisis, and includes a deep discussion on the main changes affecting gastroenterology patients and healthcare systems, anticipating the pandemic recovery scenario with future practices and policies.

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“…The range of symptomatic infection goes from mild to critical; >80% of cases are not severe[ 185 ], but morbidity and mortality are not negligible. Current evidence shows that the IBD population does not have an increased prevalence of SARS-CoV-2 infection[ 186 - 188 ] and immunomodulators, biologics, or Janus Kinase inhibitors do not represent a risk factor for SARS-CoV-2 infection and more severe COVID- 19[ 189 , 190 ]. On the other hand, in several studies of IBD patients with COVID-19, a trend towards an adverse outcome with concomitant corticosteroids was reported[ 191 ].…”

Section: Viral Diseasesmentioning

confidence: 99%

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

Craviotto¹,

Furfaro²,

Loy³

et al. 2021

WJG

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Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’ lives. This practical review supports this standard of care to improve knowledge in this subject area.

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Impact of the COVID-19 outbreak and the serum prevalence of SARS-CoV-2 antibodies in patients with inflammatory bowel disease treated with biologic drugs

Cited by 19 publications

References 23 publications

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology

COVID‐19 in gastroenterology: Where are we now? Current evidence on the impact of COVID‐19 in gastroenterology

Viral infections in inflammatory bowel disease: Tips and tricks for correct management

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