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IBD Patient Guidance: COVID-19

Regarding COVID-19 and your IBD care, we would like to highlight 3 important points:

  • Continue your IBD medications as they were prescribed. It is far better to continue the medications and stay in remission vs. having a flare with a potential hospital admission.
  • Practice physical distancing – telecommute if possible and avoid any unnecessary contacts.
  • Contact your IBD doctor if you have fever or other flu-like symptoms, and with any questions.

Our IBD Center has put together the following comprehensive guidelines and information for our patients with compromised immune systems:

  • Patients who have compromised immune systems should not be in group settings in the setting of COVID-19.
  • We do not recommend any travel for any patients.
  • We recommend working remotely when possible.
  • We recommend continuing medications including infusions and injections unless you have been exposed to COVID-19. Having active bowel inflammation is a bigger risk for infection than being on your medications that are controlling the overactive immune system of IBD. Being off medications places you at risk for a relapse, which could mean steroids, which would be worse than appropriately dosed effective IBD medications.
  • If you are receiving infusions, please contact the infusion center if you have had any fever, cough, shortness of breath, or new onset diarrhea in the last 2 weeks.
  • Please do not come to clinic visit, endoscopy, or infusion appointments with any of the above symptoms.
  • We are recommending that you obtain a 3 month supply of your medications. If you need a prescription for a 3 month supply of your IBD medication please contact your provider’s office.
  • Please check the Johns Hopkins Hospital Epidemiology and Infection Control website daily: https://www.hopkinsmedicine.org/coronavirus).
  • Follow us on twitter @IBDHopkins for regular updates on COVID-19 and IBD that can affect your care.
  • The Crohn's and Colitis Foundation is also available as a resource and has worked with Drs. Jami Kinnucan, chair Patient Education, and Mark Mattar, to post the following guidance: https://www.crohnscolitisfoundation.org/what-ibd-patients-should-know-about-2019-novel-coronavirus-covid-19 As the CDC provides new information the Foundation will work to ensure the IBD Community is appropriately informed.

Frequently Asked Questions regarding COVID-19:

What is Coronavirus, how is it spread and what are the symptoms?

What should I do if I feel sick?

How can my GI provider help me?

Notify your GI provider if you are ill. Johns Hopkins GI offers Telemedicine visits and your doctor can care for you without seeing you in person to minimize your exposure to infected people.

If you have a scheduled visit that you would like to have in person please call your doctor to discuss best recommendations and potential risks. Remember to refill your medications. Our doctors and nurses are available to provide refills during this time.

What if I think I need to be tested?

If you have symptoms that you think might be the Coronavirus please contact your primary care doctor. If you don't have one let us know.

What does this mean for IBD patients?

IBD is a condition of an overactive immune system, and is often treated with immune modification or immune suppression. IBD patients on immunosuppressive medications are in general, more susceptible to infection. Specifically, being on steroids or immunomodulators like azathioprine, 6-MP, or methotrexate can increase an IBD patient's risk for viral infections. To date, we do not have any specific research on COVID-19 in IBD patients. If you test positive for COVID-19, please let us know and consider allowing us to add you to a registry so we can learn how this virus affects our patients and how best to care for them.

Concerning biologics, anti-TNF therapies are associated with bacterial or even fungal infections more commonly. Viral infections certainly can occur but are not as typical given the mechanism of the target (TNF). Vedolizumab (Entyvio) and ustekinumab (Stelara) have many fewer (or no) infections. There is actually emerging information that some of our anti-inflammatory medications like Humira may be protective of infections or of complications from COVID19--but these are very preliminary studies.

Please do not delay/stop your therapy, having active bowel inflammation is a bigger risk for infection than being on your medications that are controlling the overactive immune system of IBD. Being off medications places you at risk for a relapse, which could mean steroids, which would be worse than appropriately dosed effective IBD medications.

Please refer to this website for answers to other commonly asked questions about COVID-19. This site is updated frequently.