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Are people with IBD at higher risk of COVID-19?

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One study in the Journal of Crohn’s and Colitis notes that the evidence suggests that people with Inflammatory Bowel Disease (IBD), do not have an increased risk of COVID-19. 

However, there are some factors for people with IBD to consider. 

For example, some treatments for IBD may suppress the immune system, putting a person at greater risk of infections such as SARS-CoV-2. This includes drugs such as: 

immunomodulators, including methotrexate, azathioprine, and 6-mercaptopurine 

Janus kinase inhibitors, such as tofacitinib 

long-term steroids, such as hydrocortisone, prednisone, and methylprednisolone 

anti-tumor necrosis factor biologics, including infliximab, adalimumab, and golimumab 

other biologic drugs, such as vedolizumab and ustekinumab 

These drugs may suppress the immune system to help control IBD symptoms. However, this same function may also put people at greater risk of COVID-19 or its complications. 

Anyone taking these types of drugs should not stop taking them without consulting a doctor first. Stopping medication abruptly may cause symptom flare-ups. 

A study in The Lancet Gastroenterology & Hepatology notes that people whose conditions are stable should continue taking their medications. Anyone who is uncertain about their treatment or who is experiencing a symptom flare-up should contact their doctor. 

Anyone who had previously scheduled surgeries or endoscopies should consider postponing these during the COVID-19 pandemic. They should discuss all options with a doctor in each case. 

Other people who may be at higher risk of COVID-19 include: 

pregnant women 

people over the age of 65 

people with active-stage IBD who are at risk of malnutrition 

those with other underlying health conditions, such as diabetes or heart disease 

A person with IBD who also fits into one or more of these categories may be at greater risk of infection. 

Complications 

Anyone with IBD who starts experiencing symptoms of COVID-19 — such as a fever, a dry cough, or shortness of breath — should call their doctor to discuss their treatment options. 

Some people may experience a worsening of IBD symptoms if they have COVID-19. 

Although the most common symptoms of COVID-19 occur in the airways, a study in The Lancet Gastroenterology & Hepatology notes that around 4–6% of people with COVID-19 experience digestive symptoms such as nausea, vomiting, or diarrhea. 

In people with IBD who already experience digestive symptoms such as diarrhea, this may mean a worsening of symptoms. 

Severe complications from the disease may include difficulty breathing that requires medical intervention. Also, in cases where the infection worsens diarrhea, the person may also be at increased risk of malnutrition. 

Anyone who experiences symptoms such as shortness of breath, a constant pressure in the chest, or a bluish tint to the skin of their face or lips needs emergency medical care. 

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