Published online Mar 21, 2021. doi: 10.3748/wjg.v27.i11.1022
Peer-review started: January 24, 2021
First decision: February 10, 2021
Revised: February 11, 2021
Accepted: March 11, 2021
Article in press: March 11, 2021
Published online: March 21, 2021
Managing inflammatory bowel disease (IBD) during the coronavirus disease 2019 (COVID-19) pandemic has been a challenge faced by clinicians and their patients, especially concerning whether to proceed with biologics and immunosuppressive agents in the background of a global outbreak of a highly contagious new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2). The knowledge about the impact of this virus on patients with IBD, although it is still scarce, is rapidly evolving. In particular, concerns surrounding medications’ impact for IBD on the risk of acquiring SARS-CoV-2 infection or developing COVID-19, and potentially exacerbate viral replication and the COVID-19 course, are a current thinking of both practicing clinicians and providers caring for patients with IBD. Managing patients with IBD infected with SARS-CoV-2 depends on both the clinical activity of the IBD and the occasional development and severity of COVID-19. In this review, we summarize the current data regarding gastrointestinal involvement by SARS-CoV-2 and pharmacologic and surgical management for IBD concerning this infection, and the COVID-19 impact on both the patient's psychological functioning and endoscopy services, and we concisely summarize the telemedicine roles during the COVID-19 pandemic.
Core Tip: The knowledge on coronavirus disease 2019 (COVID-19) is rapidly evolving. Although patients with inflammatory bowel disease (IBD) do not appear to be at increased risk for COVID-19, the potential impact of immunosuppressive therapies on patients with IBD infected with severe acute respiratory syndrome coronavirus 2 calls for concern for clinicians and patients. Several recommendations and guidelines have recently been published, including the necessary reorganization of gastroenterology and endoscopy services to attendance of these patients, the growing role played by telemedicine, and the importance of addressing aspects of mental health in this context. We provide an overview and practical guidance for managing patients with IBD medically and surgically in the COVID-19 era.