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炎症性肠病患者感染 COVID-19 的风险是否增加?

Are Patients with Inflammatory Bowel Disease at Increased Risk for Covid-19 Infection?

机构信息

Department of Systems Medicine, University of Rome 'TOR VERGATA', Rome, Italy.

Gastrointestinal Unit, ASST-Fatebenefratelli Sacco - Department of Biochemical and Clinical Sciences 'L. Sacco', University of Milan, Italy.

出版信息

J Crohns Colitis. 2020 Sep 16;14(9):1334-1336. doi: 10.1093/ecco-jcc/jjaa061.

Abstract

Crohn's disease [CD] and ulcerative colitis [UC], the main inflammatory bowel diseases [IBD] in humans, are chronic, immune-inflammatory diseases, the pathogenesis of which suggests a complex interaction between environmental factors and genetic susceptibility. These disabling conditions affect millions of individuals and, together with the drugs used to treat them, can put patients at risk of developing complications and other conditions. This is particularly relevant today, as coronavirus disease [Covid-19] has rapidly spread from China to countries where IBD are more prevalent, and there is convincing evidence that Covid-19-mediated morbidity and mortality are higher in subjects with comorbidities. The primary objectives of this Viewpoint are to provide a focused overview of the factors and mechanisms by which the novel severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] infects cells and to illustrate the link between such determinants and intestinal inflammation. We also provide clues about the reasons why the overall IBD population might have no increased risk of developing SARS-CoV-2 infection and highlight the potential of cytokine blockers, used to treat IBD patients, to prevent Covid-driven pneumonia.

摘要

克罗恩病(CD)和溃疡性结肠炎(UC)是人类主要的炎症性肠病(IBD),是慢性的免疫炎症性疾病,其发病机制表明环境因素和遗传易感性之间存在复杂的相互作用。这些使人丧失能力的疾病影响着数以百万计的人,而且与用于治疗这些疾病的药物一起,可能使患者面临发生并发症和其他疾病的风险。在冠状病毒病(Covid-19)迅速从中国传播到 IBD 更为普遍的国家的今天,情况尤其如此,有令人信服的证据表明,患有合并症的患者的 Covid-19 介导的发病率和死亡率更高。本观点的主要目的是提供对新型严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染细胞的因素和机制的重点概述,并说明这些决定因素与肠道炎症之间的联系。我们还提供了有关为什么总体 IBD 人群可能没有增加感染 SARS-CoV-2 的风险的线索,并强调了用于治疗 IBD 患者的细胞因子阻滞剂预防 Covid 驱动性肺炎的潜力。

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