Expert Opinions on the Current Therapeutic Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: JAPAN IBD COVID-19 TASKFORCE, Intractable Diseases, the Health and Labor Sciences Research

Abstract

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has influenced all medical systems. This outbreak immediately affected gastroenterologists as well as global physicians worldwide. However, the comorbidity spectrum of digestive system in patients with COVID-19 remains unknown. Additionally, there are few data on the risk of SARS-CoV-2 infection and COVID-19 aggravation in inflammatory bowel disease (IBD). Physicians and patients have great concern about whether IBD patients are more susceptible to SARS-CoV-2 infection and have worsened disease courses. Therefore, it is necessary to precisely ascertain the risk of SARS-CoV-2 infection and the COVID-19 severity in IBD patients and to acknowledge the IBD management during the COVID-19 pandemic with clinically reliable information from COVID-19 cohorts and IBD experts' opinions.

In this review, we highlight gastrointestinal symptoms in COVID-19 and clinical questions regarding IBD management during the COVID-19 pandemic and make comments corresponding to each question based on recent publications. At the moment, we propose four key points as follows: (1) no evidence that IBD itself increases the risk of SARS-CoV-2 infection, (2) to basically prioritize the control of disease activity of IBD, (3) no need for physicians to suddenly discontinue immunomodulatory or biologic therapy in patients with quiescent IBD, and (4) a need for careful observation of elderly (>60 years old) and IBD patients receiving corticosteroid treatment during the COVID-19 pandemic.