Crohn's and Colitis Canada's 2021 Impact of COVID-19 and Inflammatory Bowel Disease in Canada: Risk Factors and Medications

Laura E Targownik; Charles N Bernstein; Peter L Lakatos; Sanjay K Murthy; Eric I Benchimol; Alain Bitton; James Guoxian Huang; M Ellen Kuenzig; Jennifer L Jones; Gilaad G Kaplan; Kate Lee; Mariam S Mukhtar; Parul Tandon; Joseph W Windsor; Remo Panaccione

doi:10.1093/jcag/gwab032

Crohn's and Colitis Canada's 2021 Impact of COVID-19 and Inflammatory Bowel Disease in Canada: Risk Factors and Medications

J Can Assoc Gastroenterol. 2021 Nov 5;4(Suppl 2):S40-S45. doi: 10.1093/jcag/gwab032. eCollection 2021 Dec.

Authors

Laura E Targownik¹, Charles N Bernstein^{2

3}, Peter L Lakatos^{4

5}, Sanjay K Murthy⁶, Eric I Benchimol^{7

8

9

10}, Alain Bitton⁴, James Guoxian Huang⁷, M Ellen Kuenzig^{7

8}, Jennifer L Jones¹¹, Gilaad G Kaplan^{12

13}, Kate Lee¹⁴, Mariam S Mukhtar¹⁵, Parul Tandon¹, Joseph W Windsor¹², Remo Panaccione¹⁶

Affiliations

¹ Division of Gastroenterology and Hepatology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
² Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
³ University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.
⁴ Department of Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada.
⁵ First Department of Medicine, Semmelweis University, Budapest, Hungary.
⁶ The Ottawa Hospital IBD Centre, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
⁷ SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁸ Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
⁹ ICES, Toronto, Ontario, Canada.
¹⁰ Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
¹¹ Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
¹² Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹³ Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
¹⁴ Crohn's and Colitis Canada, Toronto, Ontario, Canada.
¹⁵ Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
¹⁶ Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

Abstract

Inflammatory bowel disease (IBD) is a disease that results from dysregulation of the immune system and frequently requires medications that can affect the immune response to infections; therefore, it was imperative to quickly understand the risk of coronavirus disease 2019 (COVID-19) infection on persons living with IBD and how that risk may be increased by commonly used IBD medications. The IBD research community in Canada and beyond quickly established collaborative efforts to better understand the specific risk posed by COVID-19 on persons with IBD. We learned that IBD itself was not a risk factor for death or serious complications of COVID-19, and that most commonly used drug classes (with the notable exception of corticosteroids) do not increase the risk of COVID-19-related adverse outcomes. The risk factors for serious complications and death from COVID-19 appear to be similar to those identified in the wider population; those being advanced age, having pre-existing heart or lung disease, and smoking. We recommend that persons with IBD do not alter their course of therapy to avoid complications of COVID-19, though the indiscriminate use of corticosteroids should be avoided. Persons with IBD should follow the same public health recommendations as the general population to reduce their personal risk of acquiring COVID-19.

Keywords: Biologics; COVID-19; Inflammatory bowel disease; Risk factors.