The main concern in inflammatory bowel disease (IBD) patients on anti-TNFα antibodies during SARS-CoV-2 pandemic is the potential consequence of immunosuppressive therapy. Despite the initial concern that such treatment could lead to a more severe disease course, recent evidence suggests that in a significant proportion of patients it is the activation of the immune system, and not the virus
Itself, that causes severe lung damage. Thus, it was hypothesized that the use of anti TNFα antibodies could be beneficial in SARS-CoV-2 infection. TNFα has various biological effects such as amplification of proinflammatory and chemotactic mediators, migration of neutrophils and up-regulation of adhesion molecules. Therefore, besides direct cytopathic effect of SARS-CoV-2, suppressing of host inflammatory response could serve as another treatment option.
Furthermore, a randomized controlled trial investigating efficacy and safety of adalimumab in the treatment of patients with severe Covid-19 pneumonia has recently been registered [3]. Since the evidence is scarce and there is a rising interest on the effect of anti TNFα antibodies in SARS-CoV-2 infection, we report, to our knowledge, the first case of SARS-CoV-2 infection in Crohn’s disease (CD) patient on intensified adalimumab treatment with favorable clinical course.
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Covid-19 Infection in Patients with Crohn's Disease on Intensified Adalimumab Treatment with Gastrointestinal Symptoms (fortunejournals.com)