COVID-19 is the illness that the new coronavirus, SARS-CoV-2, causes. The virus primarily spreads through contact with infected people or surfaces. Crohn’s disease is an inflammatory bowel disease (IBD) that causes mainly digestive symptoms.
The two conditions are unrelated, but people with Crohn’s disease should be aware of certain factors regarding COVID-19.
A person’s general health may play a role in their risk for COVID-19. Additionally, some treatment options, such as immunosuppressants, may increase the risk for infectious illnesses such as COVID-19.
People with Crohn’s should talk to their doctor about their treatment options, but they should not stop taking any medication unless a doctor advises it.
There are also several prevention tips that apply to both the general public and people who are more at risk for infections or complications.
Keep reading to learn more.
Crohn’s disease does not affect everyone in the same way. Some people with this condition may experience mild-to-moderate symptoms, whereas in other cases, symptoms may be severe.
Currently, people with IBD who do not have severe inflammation, do not take immunosuppressors, and are not malnourished should have about the same level of risk as the general population.
A study in the Journal of Crohn’s and Colitis confirms this, noting that overall, the evidence suggests that people with IBD have no increased risk of COVID-19 infection compared with the general population.
However, some treatments for Crohn’s may modify or suppress the immune system, which may increase a person’s risk. These drugs include:
- steroids, such as prednisone, methylprednisolone, and hydrocortisone
- immunomodulators, such as methotrexate, azathioprine, and 6-mercaptopurine
- JAK inhibitor drugs, such as tofacitinib
- anti-TNF biologic drugs, such as infliximab, golimumab, and adalimumab
- other biologics, such as vedolizumab and ustekinumab
People who take immunosuppressive medications may be at an increased risk of infections and serious complications from infections. However, people taking these medications should not stop taking them unless it is under the direct guidance of a doctor.
Other treatments, including the drug mesalamine (or mesalazine), do not suppress the immune system. Research in The Lancet Gastroenterology & Hepatology notes that mesalamine should not increase the risk of infection and that people taking this drug should continue to do so.
However, researchers do not recommend that doctors make new prescriptions or increase the dosages of drugs that modify the immune system during the pandemic.
COVID-19 primarily affects the airways and respiratory system. It may cause other symptoms similar to those of common respiratory infections, such as a stuffy or runny nose and general aches and chills.
In some cases, people with COVID-19 experience digestive issues, such as nausea, vomiting, or diarrhea. These may be similar to the signs of IBD and might make a person feel as though they are having a flare-up. Other signs and symptoms may help differentiate the two.
More severe complications of COVID-19 are also possible. These symptoms may include:
- difficulty breathing
- pain or pressure in the chest
- inability to focus
- difficult for others to rouse the person
- loss of color or bluish hue in the lips and face
Severe reactions may be more likely in people who are at higher risk for complications, including those over the age of 65 years and individuals with other health conditions, such as:
- lung disease
- moderate-to-severe asthma
- heart disease
- severe obesity
- chronic kidney or liver disease
Additionally, people who have a weakened immune system may be at a higher risk for infections. These people include those who smoke, have immune deficiencies, or are undergoing cancer treatment.
Anyone noticing severe symptoms should seek immediate medical attention.
There are a number of general prevention methods that apply to all, including people with Crohn’s. General prevention tips include:
- washing the hands regularly, using warm water and soap and lathering for at least 20 seconds
- using hand sanitizer containing at least 60% alcohol when soap is not available
- avoiding touching the mouth, eyes, or nose with unwashed hands
- avoiding close contact with people who are ill in any way
- practicing physical distancing to help reduce the impact of the virus — this involves staying at least 6 feet away from other people while in public
- disinfecting surfaces and objects in the home that see regular use
- using a tissue to cover the mouth and nose while sneezing and then disposing of the tissue immediately afterward
Additionally, anyone with symptoms of any sickness, even common illnesses such as a cold or the flu, should stay home.
Research featuring in Nature Reviews Gastroenterology & Hepatology also notes that tests have revealed the presence of live viral RNA in the fecal matter of people with COVID-19. Due to this, they advise caution when using public toilets.
The CDC now recommend that people use cloth face coverings in public settings in which it is hard to adhere to other physical distancing measures. Wearing a cloth mask over the nose and mouth while in public may help slow the transmission of SARS-CoV-2, but it is not a replacement for other practices, such as physical distancing and regular hand washing.
People taking certain medications for Crohn’s may need to take additional preventive steps. For instance, those taking immunosuppressants should further minimize their risk of infection by:
- staying home whenever possible
- stocking up on medications, food, and other supplies to have enough for a couple of weeks at a time
- avoiding crowds, public areas, and anywhere else where they may experience close contact with other people
Importantly, people who are taking immunosuppressant drugs should not stop taking the drugs unless a doctor specifically tells them to do so.
Suddenly stopping a medication may result in a flare-up of symptoms, which may put extra stress on the immune system. A person should check with a doctor and follow their specific instructions.
There are currently no vaccinations or treatments for the SARS-CoV-2 virus or COVID-19. Taking steps to prevent the spread of the infection is, therefore, very important.
Anyone who believes that they have symptoms of COVID-19 should speak with their doctor.
It is not always necessary to test for and confirm COVID-19, as most people experience a relatively mild form of the illness and do not need specialist treatment in a hospital. Recovering at home helps prevent the spread of infection.
Although there is no direct treatment, it is still important to take steps to control the symptoms. In severe cases, oxygen therapy may help prevent other complications in people having difficulty breathing.
In cases where severe symptoms lead to respiratory failure, the person may need mechanical ventilation to keep enough oxygen in their body.
Using ongoing clinical trials, researchers are working on developing treatments and vaccines.
Anyone who suspects that they have COVID-19 should call the hospital before visiting. Scheduling an appointment with the hospital allows the staff to take measures to prevent the spread of the infection.
Anyone with severe symptoms, such as shortness of breath, pain in the chest, or a bluish hue to the skin, should seek immediate medical care.
In many cases, people with Crohn’s disease will have no greater risk of getting COVID-19 than the general population. However, people who have severe inflammation, are malnourished or at risk for malnourishment, or take drugs that suppress the immune system may be more at risk.
In general, it is still important for people with Crohn’s to make healthful lifestyle choices, such as eating a balanced diet, avoiding smoking or secondhand smoke, and doing regular exercise.
It is essential to talk to a doctor before modifying or stopping any treatment. While many cases are relatively mild, and people can recover at home, anyone experiencing severe respiratory symptoms should seek medical attention.
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