A organização internacional para o estudo das DII - IOIBD - publicou recentemento um pequeno resumo do que se sabe e algumas recomendações para os doentes que se seguem.

"IOIBD Update on COVID19 for Patients with Crohn’s Disease and Ulcerative Colitis"

Coronaviruses are a family of viruses that can cause illness from the common cold to more severe diseases. The novel strain of coronavirus named SARSCoV2 was first detected in Wuhan, China and causes coronavirus disease COVID19.

How is coronavirus transmitted?
Via respiratory droplets produced when an infected person sneezes or coughs and can infect people in close contact (within 6 feet). Touching contaminated surfaces before touching your eyes/nose/mouth might also lead to infection.

How does COVID19 compare with seasonal influenza?
Both are infectious respiratory illnesses that present with symptoms such as fever, cough, and shortness of breath. Both can lead to serious illness especially in older people and those with prior medical conditions. One difference is that you can get vaccinated for the flu, but there is not a vaccine available yet for COVID19. Phase 1 studies of a possible vaccine are starting in the next 2 months according to the Centers for Disease Control in the US.

What does this mean for IBD patients?
IBD is a condition of an overactive immune system, and is often treated with immune modification or immune suppression. IBD patients on immunosuppressive medications are in general, more susceptible to infection. Specifically, being on steroids or immune modulators like azathioprine or 6-mercaptopurine or methotrexate can increase an IBD patient's risk for viral infections. To date, we don’t have specific IBD research on COVID19.

What are the current recommendations for IBD patients related to COVID19?
Many patients have already asked us if they should stop their medications. Medicines such as mesalamine (brand names include Asacol, Apriso, Balsalazide, Lialda, Pentasa) are all safe. It is always a good idea to get off of steroids such as prednisone/prednisilone, if this is possible. Thiopurines (6-mercaptopurine, azathioprine) and tofacitinib tend to inhibit the body’s immune response to viral infections. The thiopurines take months to leave the body. Thus stopping these will not help in the short term. The biologics we currently use to treat IBD such as anti-TNFs (Cimzia, Humira, Remicade, Simponi), ustekinumab (Stelara), vedolizumab (Entyvio) are generally safe. At present we do not recommend stopping these medications. Moreover, the effect of these medications stay in the body, in many cases, for months. We will keep updating these recommendations as more data become available.

Additional recommendations for everyone:
1. Avoid being in close contact with sick people.
2. Wash your hands frequently.
3. Avoid touching your nose, eyes and mouth.
4. Seek medical attention in case of fever, cough or difficulty breathing.
5. If you haven’t, get your flu shot!

There is still a lot we don’t know about COVID19 and we will update and be more specific about our recommendation in the very near future.

IOIBD website
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