Managing <scp>COVID</scp>‐19 in patients with inflammatory bowel disease: navigating unprecedented challenges

Prentice, Ralley E; Al‐Ani, Aysha; Christensen, Britt

doi:10.1111/imj.15190

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…A meta-analysis considering 96,852 patients reported that the use of corticosteroids increased the mortality of patients with COVID-19 [270], which could be due to the early use of corticosteroids facilitating the viral replication of SARS-CoV-2 due to low immune resistance, leading to an increase in viral load. Therefore, the WHO only recommends their use in critically ill COVID-19 patients at 7 days after the first symptom [271,272]. Hence, the use of this drug will depend on the timing and characteristics of each patient, in order to obtain a positive prognosis.…”

Section: Criteria To Consider For Corticosteroidsmentioning

confidence: 99%

Severe COVID-19: Drugs and Clinical Trials

Ceja-Gálvez

Renteria-Flores

Nicoletti

et al. 2023

JCM

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By January of 2023, the COVID-19 pandemic had led to a reported total of 6,700,883 deaths and 662,631,114 cases worldwide. To date, there have been no effective therapies or standardized treatment schemes for this disease; therefore, the search for effective prophylactic and therapeutic strategies is a primary goal that must be addressed. This review aims to provide an analysis of the most efficient and promising therapies and drugs for the prevention and treatment of severe COVID-19, comparing their degree of success, scope, and limitations, with the aim of providing support to health professionals in choosing the best pharmacological approach. An investigation of the most promising and effective treatments against COVID-19 that are currently available was carried out by employing search terms including “Convalescent plasma therapy in COVID-19” or “Viral polymerase inhibitors” and “COVID-19” in the Clinicaltrials.gov and PubMed databases. From the current perspective and with the information available from the various clinical trials assessing the efficacy of different therapeutic options, we conclude that it is necessary to standardize certain variables—such as the viral clearance time, biomarkers associated with severity, hospital stay, requirement of invasive mechanical ventilation, and mortality rate—in order to facilitate verification of the efficacy of such treatments and to better assess the repeatability of the most effective and promising results.

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Section: Criteria To Consider For Corticosteroidsmentioning

confidence: 99%

Severe COVID-19: Drugs and Clinical Trials

Ceja-Gálvez

Renteria-Flores

Nicoletti

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Although these, and in particular dexamethasone, are used in the treatment of severe forms of infection associated with respiratory distress [ 69 ], their use must be reserved for the second phase of the disease, when the damage mediated by the hyper-inflammatory state prevails. On the contrary, they could increase replication and viral load if used immediately [ 70 , 71 ]. It has been demonstrated that the chronic use of systemic corticosteroids leads to immunosuppression.…”

Section: Drugs and Inflammatory Bowel Diseases: What Have We Learned?mentioning

confidence: 99%

Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases

et al. 2021

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Susceptibility and disease course of COVID-19 among patients with inflammatory bowel diseases (IBD) are unclear and epidemiological data on the topic are still limited. There is some concern that patients with immuno-mediated diseases such as IBD, which are frequently treated with immunosuppressive therapies, may have an increased risk of SARS-CoV-2 infection with its related serious adverse outcomes, including intensive care unit (ICU) admission and death. Corticosteroids, immunomodulators, and biologic drugs, which are commonly prescribed to these patients, have been associated with higher rates of severe viral and bacterial infections including influenza and pneumonia. It is not known whether these drugs can be so harmful as to justify their interruption during COVID-19 infection or if, on the contrary, patients with IBD can benefit from them. As shown by recent reports, it cannot be excluded that drugs that suppress the immune system can block the characteristic cytokine storm of severe forms of COVID-19 and consequently reduce mortality. Another cause for concern is the up-regulation of angiotensin converting enzyme-2 (ACE2) receptors that has been noticed in these patients, which could facilitate the entry and replication of SARS-CoV-2. The aim of this narrative review is to clarify the susceptibility of SARS-CoV-2 infection in patients with IBD, the clinical characteristics of patients who contract the infection, and the relationship between the severity of COVID-19 and immunosuppressive treatment.

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“…At the beginning of the pandemic, the use of corticosteroids was considered controversial, although Randomized Evaluation of COVID-19 Therapy (RECOVERY) trial provided evidence that dexamethasone 6 mg once daily for 10 days reduced mortality in COVID-19 patients receiving oxygen therapy [16]. Some investigators noted that early corticosteroid use might lead to increased virus replication and thus higher viral loads [25]. Meanwhile, there is an analysis suggesting that the initiation of treatment in the second week of symptom onset, when the immunopathological phenomenon dominates, may be beneficial [16].…”

Section: Introductionmentioning

confidence: 99%

Potential Adverse Effects of Dexamethasone Therapy on COVID-19 Patients: Review and Recommendations

et al. 2021

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In the context of the coronavirus disease 2019 (COVID-19) pandemic, the global healthcare community has raced to find effective therapeutic agents against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, dexamethasone is the first and an important therapeutic to significantly reduce the risk of death in COVID-19 patients with severe disease. Due to powerful anti-inflammatory and immunosuppressive effects, dexamethasone could attenuate SARS-CoV-2-induced uncontrolled cytokine storm, severe acute respiratory distress syndrome and lung injury. Nevertheless, dexamethasone treatment is a doubleedged sword, as numerous studies have revealed that it has significant adverse impacts later in life. In this article, we reviewed the literature regarding the adverse effects of dexamethasone administration on different organ systems as well as related disease pathogenesis in an attempt to clarify the potential harms that may arise in COVID-19 patients receiving dexamethasone treatment. Overall, taking the threat of COVID-19 pandemic into account, we think it is necessary to apply dexamethasone as a pharmaceutical therapy in critical patients. However, its adverse side effects cannot be ignored. Our review will help medical professionals in the prognosis and follow-up of patients treated with dexamethasone. In addition, given that a considerable amount of uncertainty, confusion and even controversy still exist, further studies and more clinical trials are urgently needed to improve our understanding of the parameters and the effects of dexamethasone on patients with SARS-CoV-2 infection.

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Managing COVID‐19 in patients with inflammatory bowel disease: navigating unprecedented challenges

Cited by 4 publications

References 14 publications

Severe COVID-19: Drugs and Clinical Trials

Severe COVID-19: Drugs and Clinical Trials

Risk, Course, and Effect of SARS-CoV-2 Infection in Children and Adults with Chronic Inflammatory Bowel Diseases

Potential Adverse Effects of Dexamethasone Therapy on COVID-19 Patients: Review and Recommendations

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