Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal; Department of Gastroenterology, Centro Hospitalar de São João, Porto, Portugal; Department of Clinical Pharmacology Centro Hospitalar de São João, Porto, Portugal.
CHU UCL Namur, Université catholique de Louvain, service de Hépato-gastroentérologie, Yvoir, Belgium.
J Crohns Colitis. 2020 Oct 21;14(14 Suppl 3):S798-S806. doi: 10.1093/ecco-jcc/jjaa160.
Our knowledge of COVID-19 is changing and evolving rapidly, with novel insights and recommendations, almost on a daily basis. It behooves the medical community to provide updated information on a regular basis, on best practice to facilitate optimal care of infected patients and on appropriate advice for the general population. This is particularly important in the case of patients with chronic conditions, such as inflammatory bowel disease [IBD]. In this review, we have compiled existing evidence on the impact of COVID-19 in IBD patients and provide guidance on the most appropriate care to adopt during the pandemic. Our review highlights that IBD, per se, is not a risk factor for COVID-19. However, all IBD patients with symptoms should be tested for SARS-CoV-2 and the procedures for disease management should be carefully adapted: [i] in SARS-CoV-2-positive IBD patients, medical treatments should be re-evaluated [with a particular focus on corticosteroids] always with the purpose of treating active disease and maintaining remission; [ii] non-urgent surgeries and endoscopic procedures should be postponed for all patients; [iii] online consultancy should be implemented; and [iv] hospitalization and surgery should be limited to life-threatening situations.
我们对 COVID-19 的认识正在迅速变化和发展,几乎每天都有新的见解和建议。医学界有责任定期提供最新信息,介绍最佳实践,以促进感染患者的最佳护理,并为普通民众提供适当的建议。对于患有慢性疾病(如炎症性肠病 [IBD])的患者来说,这一点尤为重要。在本综述中,我们汇集了 COVID-19 对 IBD 患者影响的现有证据,并就大流行期间应采取的最适当护理提供指导。我们的综述强调,IBD 本身并不是 COVID-19 的危险因素。然而,所有出现症状的 IBD 患者都应接受 SARS-CoV-2 检测,并且应仔细调整疾病管理程序:[i] 在 SARS-CoV-2 阳性的 IBD 患者中,应重新评估医学治疗(特别关注皮质类固醇),始终以治疗活动期疾病和维持缓解为目的;[ii] 应推迟所有患者的非紧急手术和内镜检查;[iii] 应实施在线咨询;[iv] 应将住院和手术限于危及生命的情况。