Institute of Liver, Gastroenterology and Pancreaticobiliary Sciences, Sir Ganga Ram Hospital , New Delhi, India.
Expert Rev Gastroenterol Hepatol. 2020 Dec;14(12):1187-1193. doi: 10.1080/17474124.2020.1816822. Epub 2020 Sep 2.
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread world over causing morbidity and mortality in affected patients, especially elderly and those with co-morbidities. Inflammatory Bowel Disease (IBD) patients frequently require immunosuppressive therapy and are known to be at risk of opportunistic infections.
We hereby review the available literature pertaining to COVID-19 in IBD based on published consensus guidelines, expert opinions, case series, registries and reports.
Preliminary data suggests no increase in incidence of COVID-19 in IBD patients as compared to general population. Morbidity and mortality rates attributable to COVID-19 are also similar in IBD patients as compared to general population. Though exact reason is unknown, some aspects of COVID-19 pathogenesis may explain this paradox. Medications for IBD need to be carefully reviewed during COVID-19 crisis. Steroids may need dose tapering or substitution to avoid complications based on anecdotal evidence. Endoscopic procedures for IBD maybe deferred unless absolutely necessary. General measures recommended for COVID-19 tailored to specific needs of IBD patients maybe the best way to prevent infection. Our understanding of the disease outcomes and optimal management protocols are likely to evolve as we move ahead in this pandemic.
由严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）引起的 2019 年冠状病毒病（COVID-19）已在全球迅速蔓延，导致受影响患者（尤其是老年人和伴有合并症的患者）出现发病率和死亡率。炎症性肠病（IBD）患者经常需要接受免疫抑制治疗，并且已知他们有机会感染的风险。
根据已发表的共识指南、专家意见、病例系列、登记处和报告，我们在此回顾了与 IBD 相关的 COVID-19 的现有文献。
初步数据表明，IBD 患者 COVID-19 的发病率与普通人群相比没有增加。COVID-19 在 IBD 患者中的发病率和死亡率与普通人群相比也相似。尽管确切原因尚不清楚，但COVID-19 发病机制的某些方面可以解释这种矛盾。在 COVID-19 危机期间，需要仔细审查用于治疗 IBD 的药物。根据经验证据，为避免并发症，可能需要逐渐减少或替代类固醇剂量。除非绝对必要，否则可能会推迟 IBD 的内镜检查程序。针对 IBD 患者的特定需求制定的 COVID-19 一般推荐措施可能是预防感染的最佳方法。随着我们在这场大流行中的前进，我们对疾病结局和最佳管理方案的理解可能会发生变化。
