Although a person with ulcerative colitis (UC) may not develop severe illness from COVID-19, some UC medications may weaken their immune system.
In this article, we look at how COVID-19 may affect people with UC and explain what precautions a person should take.
However, some medications for UC, such as steroids, are immunosuppressive and can weaken a person’s immune system. According to the Centers for Disease Control and Prevention (CDC), those who have a weakened immune system may be at a higher risk of developing a severe illness as a result of COVID-19.
Other people whom doctors currently know to be at a higher risk for severe illness include those:
- over the age of 65 years
- who live in long-term care facilities, such as nursing homes
- living with diabetes
- who have severe obesity, with a body mass index (BMI) over 40
- on dialysis or with chronic kidney disease
- with liver disease
- with chronic lung or breathing conditions, such as severe asthma
- with serious heart disease
A person should not stop taking their medication.
UC can cause inflammation in the digestive tract. Preliminary research suggests that chronic inflammation may be a risk factor for severe complications from COVID-19. Some UC medications slow or even reverse this inflammation.
Aminosalicylates do not suppress the immune system and do not increase the risk of developing COVID-19 complications.
Some aminosalicylates include:
Immunomodulators and biologics may weaken the immune system, but current guidelines do not recommend quitting them.
These drugs include:
- thiopurines, such as cyclosporine and methotrexate
However, taking steroids, such as prednisone, for extended periods can weaken the immune system. According to the Crohn’s & Colitis Foundation, a person should talk to a doctor about switching medication or lowering the dosage.
Early in the pandemic, some advocates suggested avoiding nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. The authors of a letter featuring in The Lancet suggest that these drugs may activate an enzyme that intensifies COVID-19 symptoms.
According to the Food and Drug Administration (FDA), there is no research supporting this claim. However, the virus is new, and scientists need time to investigate further. Other types of pain relievers may work as alternatives to NSAIDs.
A person should talk to a doctor about the risks and benefits of continuing their medication.
People who need infusions for UC should not stop getting them.
It may be possible to do infusions at home. A person can talk to a healthcare provider about this option.
If infusions must happen in a doctor’s office, these strategies can help reduce the person’s risk of contracting the SARS-CoV-2 virus:
- Wait in the car, not in the waiting room, and ask the doctor to call when they are ready.
- Take hand sanitizer and sanitize the hands after touching any surfaces.
- Wipe down all surfaces with disinfecting wipes containing either bleach or alcohol.
- Schedule the visit during off-peak hours.
- Ask about strategies to minimize contact with others. For example, it may be possible to check in online and fill out forms before arriving at the office.
People may transmit SARS-CoV-2 even before they develop symptoms.
The following strategies can slow the spread of the virus and greatly reduce a person’s risk of getting it:
- Practice physical distancing: Do not go out in public at all unless necessary. Reschedule nonessential medical appointments, and avoid any contact with people outside of the household.
- Be careful when outside: When it is necessary to go to the store, go during off-peak hours, and wear a mask. Wash the hands, use hand sanitizer, and avoid touching the face before and after the trip.
- Choose delivery whenever possible: Home grocery delivery and buying supplies through the mail can decrease exposure to the virus.
- Regularly wash the hands: A person should wash their hands with soap and warm water, especially after any contact with other people or potentially contaminated surfaces. A person can learn how to wash their hands properly here.
- Telemedicine: Ask a doctor about switching to telemedicine for routine appointments.
- Stock up on UC medication: Ask a doctor about extending prescriptions.
Children have a much lower risk than adults of developing severe COVID-19 symptoms.
However, parents and caregivers should closely monitor children for signs of the disease and call a doctor right away if a child has trouble breathing or their UC symptoms get worse.
The same preventive measures that can protect adults will protect children.
It is advisable to see a doctor if:
- a person develops symptoms of COVID-19, such as shortness of breath, fever, or chest pain
- UC symptoms get worse
- a person has questions about UC medication and COVID-19
If possible, people should call ahead before visiting the doctor in case they need to put any safety measures in place.
If a person cannot breathe, looks blue, or loses consciousness, someone should take them to the emergency room or call 911. Call ahead of time or alert the 911 dispatcher that the person may have COVID-19.
SARS-CoV-19 is a serious infection that may affect people with preexisting medical issues.
Although there is not yet any research suggesting that UC is a risk factor for contracting the virus, people with UC can reduce their risk by behaving as though they are high risk.
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