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What IBD Patients Should Know About COVID-19

Patient asking about their risk of contracting COVID-19 or developing severe complications with IBD

COVID-19 has disrupted life around the globe and, amid misinformation and uncertainty, raised unprecedented levels of anxiety. The concern is amplified among those who already have an existing medical condition, such as Crohn's disease, or a weakened immune system.

Nearly half (48%) of Americans reported missing or delaying care because of COVID-19, with 11% saying their condition had worsened as a result, according to a recent poll.

For individuals dealing with inflammatory bowel disease (IBD), the overwhelming stress brought by the pandemic can be a trigger for flare-ups. Fear of infection has also led some to not visit pharmacies to refill their prescriptions. It's also raised concerns as to whether patients might take the vaccine when it's available.

Combating confusion

Gil Y. Melmed, MD

Cedars-Sinai IBD specialists say they have been fielding a flood of questions about whether the gut condition makes them more vulnerable to COVID-19 or its complications.

"There's fear and misperceptions going around," says gastroenterologist Dr. Gil Melmed, co-director of Clinical Inflammatory Bowel Disease at Cedars-Sinai.

A vast majority (87%) of IBD patients were afraid of contracting the virus or infecting others, while nearly one-third believed the illness made them more susceptible to COVID-19, according to research published in The Lancet. Nearly two-thirds of the participants believed immunosuppressant drugs also placed them at a higher risk.

Patients also felt they needed more guidance: Most (60%) said they wanted more COVID-19 prevention recommendations from their provider, and about one-fourth were dissatisfied with what their doctor did offer. Further, very few (11%) felt a medical consultation eased their coronavirus worries.

The expert inflammatory bowel disease care team at Cedars-Sinai points out that the medical community has learned a lot since the novel coronavirus first appeared about how it affects those with the chronic condition. Here are five things you should know about IBD and COVID-19:

IBD doesn't place you at higher risk of contracting the virus that causes COVID-19

It also doesn't worsen risk of complications or death for COVID-19 patients, unless you have other risk factors such as older age, obesity, underlying diabetes, or heart and lung disease.

"These conditions can predispose IBD patients to more serious complications if they are infected, just like they would to anyone who doesn't have IBD," says Melmed.

IBD medications don't make you more vulnerable to COVID-19 complications—with one exception

Routine prescription IBD drugs, even immune-suppressing therapies or biologics, don't put you at higher risk either, according to Melmed. Patients should continue taking all their regular IBD medications as prescribed.

The only exception is for patients taking corticosteroids, such as prednisone, for chronic IBD. Some steroids might make you more likely to get very sick from COVID-19.

Continue following safety protocols

To limit COVID-19 transmission, the Centers for Disease Control and Prevention (CDC) suggests wearing face masks in public, physical distancing of at least 6 feet, limiting in-person contact as much as possible, and frequent hand-washing and disinfecting.

"The Pfizer and Moderna vaccines should not pose any increased risk to people with IBD, regardless of the medications they might be on"

Get vaccinated

Cedars-Sinai's IBD experts are urging all patients over the age of 16 to receive the vaccine at the earliest possible opportunity. The FDA approved emergency use authorization for the first COVID-19 vaccine in early December, and Cedars-Sinai has now initiated a rollout to frontline workers.

"We still need to understand more about how long these vaccines might be effective in people with IBD and will be studying this in a long-term registry here at Cedars-Sinai," he adds.

Stay in contact with your doctor

Check in with your specialist or primary care physician regularly for updates on when the vaccine will be available to you. Vaccine prioritization guidelines are set by the CDC and local public health departments.

In the meantime, keep in contact with your doctor for routine health management and COVID-19 prevention, especially if you're on an immune-suppressing steroid.

The Crohn's & Colitis Foundation adds that you should always discuss any recommendation you see on TV, social media or online with your healthcare team.