When I and the other co-chairs of the 2020 Advances in IBD (AIBD) virtual conference (www.advancesinibd.com) had to pivot to doing things virtually for the most recent meeting, we were worried about losing some attendees. In fact, we received fantastic feedback and had more than 2,500 attendees—one of our highest attendance rates—with participants representing more countries than ever. Part of the reason for the success of the meeting is that the participants did not need to travel, but it likely also speaks to the fact that AIBD has quickly become the premier meeting for inflammatory bowel disease education in the United States.
One of the highlights of the conference was a full-day session on COVID-19, which incidentally took place on the same day as the emergency use authorization of the first COVID-19 vaccine in this country. The main discussions during the session centered on existing research and lessons from the SECURE-IBD registry.
Collectively, our knowledge to date has demonstrated that patients with IBD are not more likely to develop COVID-19 simply by having Crohn’s disease or ulcerative colitis. Also, if they get COVID-19, it is no more likely to be severe than if one didn’t have IBD. Of note, IBD medications appear largely safe and do not increase complications related to COVID-19, the one exception being high-dose steroids, which we should try to avoid using in our IBD patients regardless.
The key message is that IBD patients receiving biologics or immunosuppressants who are in remission should not discontinue their medications out of fear of COVID-19. An interruption of medical treatment may cause patients to experience a flare of IBD that may require hospitalization.
Of course, patients should consult their physicians if they get COVID-19, and there are recommendations to guide physicians in making medication decisions in these situations (Gastroenterology 2020;159[1]:6-13.e6). Those recommendations should be helpful for clinicians, given that despite recurrent messaging, publications and announcements on the topic, providers are still unsure whether IBD patients should stop their medications because of concerns of contracting COVID-19. In addition to questions on this topic during the session at AIBD, there were many questions about the COVID-19 vaccine, which we recommend that our IBD patients receive, and again there is no need to stop IBD medicines when vaccinated.
IBD and COVID-19 Stats From The SECURE-IBD Registrya:
- Worldwide total COVID-19 cases in IBD patients reported to SECURE-IBD: 4,735
- Age of the majority of reported cases: 20 to 59 years
- Severe diseaseb in patients receiving an anti–tumor necrosis factor agent without 6-mercaptopurine/ azathioprine or methotrexate: 1%
- Severe disease in those receiving oral or parenteral steroids: 14%
- Severe disease in patients receiving budesonide: 6%
- Severe disease among those in remission: 4%
- Severe disease in patients with moderately to severely active disease: 6%
- Severe disease among those without comorbidities: 2%
- Severe disease in patients with one comorbidity: 6%
- Severe disease among individuals with three or more comorbidities: 34%
Another highlight of the meeting—and perhaps one of the most important improvements we made to AIBD this year—was having patients participate in panels and discussing research, clinical topics and education. As physicians and health care providers, we are knowledgeable about disease and treatments, but we may not have IBD. Inviting patients to share their perspectives was impactful. On our COVID-19 panel, for example, a patient was able to talk about some of their fears around getting COVID-19 as someone with IBD. To hear the personal impact that IBD has on somebody living with it was very humbling, instructive and educational. Certainly, as we go forward, we want to continue to ensure the patient’s voice is heard loudly at AIBD, as well as at other conferences.
IBD Patients to Follow on Twitter:
Amber @aboutIBD
Chronically Jess @ChronicallyJess
Dan Sharp @DanSharpIBD
GutlessandGlamorous @GutlessGlamour
Guts & Glory @GtsNGlry
Natalie Hayden @nataliesparacio
Sarah Fleetwood-Beresford @Sarah88uk
The Bottom Line (IBD) @bottomlineibd
TheCrazyCreoleMommy @CrzyCreoleMommy
Tina Own Your Crohn’s @ownyourcrohns
—Compiled and written by David Wild
This article is from the April 2021 print issue.