COVID-19 and inflammatory bowel disease — what to know

Inflammatory bowel disease (IBD) represents a chronic inflammation of the gastrointestinal tract that arises from a complex interplay between a dysregulated immune response in genetically predisposed individuals. IBD can further be classified into its two main subtypes, Crohn’s disease and ulcerative colitis. Both subtypes have shown increasing prevalence and incidence rates worldwide, and IBD is now considered a global epidemic. About three million patients are estimated to suffer from this disease, both in the US and Europe, with most of them requiring maintenance treatment including immunosuppressive agents, putting them at risk for opportunistic infections. In 2020, coronavirus disease 2019 (COVID-19) hit the world with a long pandemic period resulting in dramatic numbers of hospitalizations, Intensive care unit (ICU) admissions, and deaths. Patients with chronic illnesses, such as IBD, were rapidly considered to be at an increased risk for both infection and infection-related complications. For IBD and its treatment, however, evidence over the last few years showed no increased risk for SARS-CoV-2 infection or COVID-related complications. In this review, we will discuss the latest insights about COVID-19 in IBD patients with a particular focus on the disease course of COVID-19 and on IBD-related adverse outcomes.