Inflammatory Bowel Disease and Infection

A special issue of Vaccines (ISSN 2076-393X).

Deadline for manuscript submissions: closed (27 January 2022) | Viewed by 3418

Special Issue Editor

Department of Gastroenterology, Chaim Sheba Medical Center, Affiliated to Tel Aviv University, Tel Aviv, Israel
Interests: gastroenterology; inflammatory bowel disease; diverticular disease; patient health; application of advanced technologies in telehealth

Special Issue Information

Dear Colleagues,

The connection between inflammatory bowel disease (IBD) and infections was established soon after the classification of both Crohn’s disease ( CD) and  ulcerative colitis (UC). It is now clear that infections play an important role in pathogenesis, clinical course, and disease exacerbations during IBD. Moreover, the disease itself predisposes patients to various infections, and the infection risk rises even higher during therapy, as the most commonly used medications induce immunomodulation and inhibition. Hence, various drugs have been shown to expose patients to specific infectious agents (e.g., tuberculosis, herpes zoster). Furthermore, immunomodulation affects response to vaccinations, thus further increasing patients’ exposure to infections. As a consequence, national and international guidelines support screening tests, pretreatment vaccinations, and prophylactic therapy for specific cases. Gathering new information on any of these subjects may lead to a better understanding of the mechanism and risk factors and may help in risk stratification and the development of new therapeutic and prophylactic approaches.

Dr. Adi Lahat
Guest Editor

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Keywords

  • IBD
  • Crohn’s disease
  • Ulcerative colitis
  • Infections
  • Vaccines

Published Papers (1 paper)

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Research

9 pages, 572 KiB  
Article
COVID-19 in Patients with Inflammatory Bowel Disease: The Israeli Experience
by Lev Lichtenstein, Benjamin Koslowsky, Ami Ben Ya’acov, Irit Avni-Biron, Baruch Ovadia, Ofer Ben-Bassat, Timna Naftali, Uri Kopylov, Yael Haberman, Hagar Banai Eran, Rami Eliakim, Adi Lahat-Zok, Ayal Hirsch, Eran Zittan, Nitsan Maharshak, Matti Waterman, Eran Israeli, Idan Goren, Jacob E. Ollech, Henit Yanai, Bella Ungar, Benjamin Avidan, Dana Ben Hur, Bernardo Melamud, Ori Segol, Zippora Shalem, Iris Dotan, Selwyn H. Odes, Shomron Ben-Horin, Yf’at Snir, Yael Milgrom, Efrat Broide, Eran Goldin, Shmuel Delgado, Yulia Ron, Nathaniel Aviv Cohen, Eran Maoz, Maya Zborovsky, Safwat Odeh, Naim Abu Freha, Eyal Shachar, Yehuda Chowers, Tal Engel, Hila Reiss-Mintz, Arie Segal, Adar Zinger and Ariella Bar-Gil Shitritadd Show full author list remove Hide full author list
Vaccines 2022, 10(3), 376; https://0-doi-org.brum.beds.ac.uk/10.3390/vaccines10030376 - 28 Feb 2022
Cited by 1 | Viewed by 2938
Abstract
Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated inflammatory bowel diseases (IBD) affecting millions of people worldwide. IBD therapies, designed for continuous immune suppression, often render patients more susceptible to infections. The effect of the immune suppression on the risk [...] Read more.
Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated inflammatory bowel diseases (IBD) affecting millions of people worldwide. IBD therapies, designed for continuous immune suppression, often render patients more susceptible to infections. The effect of the immune suppression on the risk of coronavirus disease-19 (COVID-19) is not fully determined yet. Objective: To describe COVID-19 characteristics and outcomes and to evaluate the association between IBD phenotypes, infection outcomes and immunomodulatory therapies. Methods: In this multi-center study, we prospectively followed IBD patients with proven COVID-19. De-identified data from medical charts were collected including age, gender, IBD type, IBD clinical activity, IBD treatments, comorbidities, symptoms and outcomes of COVID-19. A multivariable regression model was used to examine the effect of immunosuppressant drugs on the risk of infection by COVID-19 and the outcomes. Results: Of 144 IBD patients, 104 (72%) were CD and 40 (28%) were UC. Mean age was 32.2 ± 12.6 years. No mortalities were reported. In total, 94 patients (65.3%) received biologic therapy. Of them, 51 (54%) at escalated doses, 10 (11%) in combination with immunomodulators and 9 (10%) with concomitant corticosteroids. Disease location, behavior and activity did not correlate with the severity of COVID-19. Biologics as monotherapy or with immunomodulators or corticosteroids were not associated with more severe infection. On the contrary, patients receiving biologics had significantly milder infection course (p = 0.001) and were less likely to be hospitalized (p = 0.001). Treatment was postponed in 34.7% of patients until recovery from COVID-19, without consequent exacerbation. Conclusion: We did not witness aggravated COVID-19 outcomes in patients with IBD. Patients treated with biologics had a favorable outcome. Full article
(This article belongs to the Special Issue Inflammatory Bowel Disease and Infection)
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