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Multiple IBD patients have CORVID19, 1 doing well despite Humira + 6MP

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Ulcerative Colitis
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 3/16/2020 5:37 AM (GMT -7)
"Update 15 March #COVID19 and #IBD. Due to the active communication of colleagues around the globe, we are now aware of several worldwide cases of #COVID19 in patients who have IBD, including one child. "

"Reports that the #IBD adults are in Italy, Austria and US (NJ), the child is in Madrid, Spain.
The child has #Crohns receives Humira + 6MP. She presented with fever and cough, was not hospitalized, and is doing well.
I do not have more details on the adults yet. "

"It was expected that we would see #COVID19 affect our patients with #IBD, as it is affecting the general population too, and it is great that we have systems in place to capture and to learn from these cases in real time. The international collaboration is extraordinary."

"We still recommend that #IBD patients stay on their medical therapies and that staying in remission is best for them. There are active trials underway using some of the anti-cytokine therapies to treat #COVID19 (like anti-TNF and anti-IL6). Recs here: http://ioibd.org"

"Isolation, hand hygiene and vigilance are advised. This week (20 March) there will be an #IOIBD meeting (virtual of course) to review latest info and make additional recommendations. We will all update you then! Stay tuned, stay well. Best wishes. "

Source David T. Rubin, MD:
https://twitter.com/ibdmd/status/1239377121446899713

Source MD in Spanish:
https://twitter.com/flaviostein/status/1239226374126276611
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ks1905
Veteran Member
Joined : Sep 2005
Posts : 5857
Posted 3/16/2020 5:50 AM (GMT -7)
I thought that most children did not develop symptoms for some unknown reason. If she presented symptoms while on these medications then it makes me more concerned.

I really wish that we had test kits for the coronavirus deployed so we know w-t-f is going on.
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countess18
Regular Member
Joined : May 2016
Posts : 421
Posted 3/16/2020 8:08 AM (GMT -7)
Thanks for always keeping us informed
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 3/16/2020 11:40 AM (GMT -7)
Soem details on the adults.

Two cases of COVID-19 have been reported to the registry so far:

United States: A 35 yo female with Crohn’s disease on budesonide. This patient was hospitalized but did not require ventilator support.

Spain: A 24 yo female with ulcerative colitis on vedolizumab. This patient did not require hospitalization.

No mortalities have been reported to the registry to date. We will report further updates on medications, comorbidities, etc once we accumulate more data.

Source: https://covidibd.org/
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poopydoop
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Joined : Dec 2018
Posts : 914
Posted 3/16/2020 11:52 AM (GMT -7)
Thanks, that's a useful website
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C_G_K
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Joined : Dec 2006
Posts : 1414
Posted 3/16/2020 12:37 PM (GMT -7)
Thanks for posting.
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CCinPA
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Joined : Dec 2014
Posts : 1572
Posted 3/16/2020 2:28 PM (GMT -7)
John, I didn't see on the link where it said that they were using anti tnfs in trials for treatment of covid. Can you point me to where it's at? I want to share it with a friend who is worried about her daughter on Humira

Thanks
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ks1905
Veteran Member
Joined : Sep 2005
Posts : 5857
Posted 3/16/2020 2:35 PM (GMT -7)

CCinPA said...
John, I didn't see on the link where it said that they were using anti tnfs in trials for treatment of covid. Can you point me to where it's at? I want to share it with a friend who is worried about her daughter on Humira

Thanks

It is in Dr Rubins tweet (4 tweets down in the thread)
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 914
Posted 3/16/2020 3:07 PM (GMT -7)
I was googling this yesterday. Couldn't find much direct evidence of tnf inhibitors being trialled but I did see a study using IL-6 inhibitors. Also some studies of NAK inhibitors but unfortunately xeljanz did not inhibit the right thing...
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 3/16/2020 4:33 PM (GMT -7)

ks1905 said...
It is in Dr Rubins tweet (4 tweets down in the thread)


Correct. Here's a direct link: https://mobile.twitter.com/ibdmd/status/1239377123711823872

Furthermore:

The Chinese study of corvid19 and humira biosimilar
http://www.chictr.org.cn/showprojen.aspx?proj=49889

What's a cytokine storm in influenza?
https://www.nature.com/articles/cmi201574
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 3/16/2020 4:41 PM (GMT -7)
Thanks, John!
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 3/16/2020 4:42 PM (GMT -7)
Thanks for pointing to it, Keith!
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 914
Posted 3/16/2020 4:45 PM (GMT -7)
Ok. Anti cytokene is not (necessarily) the same as anti-tnf

Here is another article published today in the lancet re IL-6 inhibitors and JAK inhibitors

The interesting point is that they mention "a subgroup" of patients might have cytokene storm syndrome, i.e. not everyone with severe illness.

https://www.thelancet.com/journals/lancet/article/piis0140-6736(20)30628-0/fulltext?rss=yes
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CCinPA
Veteran Member
Joined : Dec 2014
Posts : 1572
Posted 3/16/2020 4:46 PM (GMT -7)
John ... the link for China may not be safe ... it turned off the privacy setting on my browser (I always use private browsing https). I didn't even read it ... when I saw what it did I closed it before it fully loaded.
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3timechamp
Veteran Member
Joined : Oct 2009
Posts : 1657
Posted 3/16/2020 6:03 PM (GMT -7)
Here in New York there setting up drive thru test areas.Great idea.N.Y has largest amount of cases in U.S.A
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 914
Posted 3/17/2020 8:51 AM (GMT -7)
Daily update from covidibd.org:

3/17/2020 Update

Four cases of COVID-19 have been reported to the registry so far:

United Kingdom: A 64 yo male with ulcerative colitis on vedolizumab and mesalamine. The patient did not require hospitalization.
Switzerland: A 23 yo male with Crohn’s disease on Infliximab. The patient did not require hospitalization.
United States: A 35 yo female with Crohn’s disease on budesonide. This patient was hospitalized but did not require ventilator support.
Spain: A 24 yo female with ulcerative colitis on vedolizumab. This patient did not require hospitalization.
No mortalities have been reported to the registry to date. We will report further updates on medications, comorbidities, etc once we accumulate more data.
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FlowersGal
Veteran Member
Joined : Missing Key Value : en-US, 577 2017
Posts : 909
Posted 3/17/2020 8:54 AM (GMT -7)
Thanks for those updates! Especially comforting to me that 2 of the patients were on entyvio and not hospitalized!
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poopydoop
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Joined : Dec 2018
Posts : 914
Posted 3/17/2020 9:13 AM (GMT -7)
Yes, also comforting to see a patient over 60 doing ok.
I am waiting for some data about xeljanz (and hoping for good news...)
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 3/17/2020 12:15 PM (GMT -7)
It's definitely encouraging this far, to know people are doing fine on our meds and with our ages with Corvid19. Our worst, initial fears are not playing out, thankfully. I'm cautiously optimistic!
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 914
Posted 3/18/2020 8:55 AM (GMT -7)
Daily update from covidibd.org. NB tofacitinib is xeljanz.

3/18/2020 Update

Eight cases of COVID-19 have been reported to the registry so far:

United States: A 35 yo female with Crohn’s disease on budesonide. This patient was hospitalized but did not require intensive care or ventilator support.
Spain: A 24 yo female with ulcerative colitis on vedolizumab. This patient did not require hospitalization.
Switzerland: A 23 yo male with Crohn’s disease on Infliximab. The patient did not require hospitalization.
United Kingdom: A 64 yo male with ulcerative colitis on vedolizumab and mesalamine. The patient did not require hospitalization.
United States: A 53 yo female with Crohn’s disease on adalimumab and sirolimus. The patient was hospitalized but did not require intensive care or ventilator support.
United States: A female with ulcerative colitis on prednisone/prednisolone and tofacitinib. The patient did not require hospitalization.
Ireland: A 41 yo male with ulcerative colitis on mesalamine. The patient did not require hospitalization.
Spain: a 50 yo male with ulcerative colitis on tofacitinib. The patient did not require hospitalization.
No mortalities have been reported to the registry to date.

The average number of days symptoms from COVID-19 among the above cases is 5 days.

--------------
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iPoop
Forum Moderator
Joined : Aug 2012
Posts : 16180
Posted 3/18/2020 10:55 AM (GMT -7)
Here's a firsthand account from a Boston USA patient with UC who got corvid19. He's on Stelara and doing fine, and not hospitalized. He was tested for Corvid19 and confirmed.

https://www.reddit.com/r/crohnsdisease/comments/fknv7s/i_had_a_mild_case_and_am_almost_recovered_from/
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Hugo18
Regular Member
Joined : Mar 2017
Posts : 150
Posted 3/18/2020 11:10 AM (GMT -7)
The best method of us Xeljanz patients to determine the risk we are at by continuing our medication may be from what other diseases that utilize the drug such as arthritis and psoriasis are finding. Xeljanz is much more in their community then the IBD world.
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momto2boys
Veteran Member
Joined : Jun 2013
Posts : 2357
Posted 3/18/2020 11:14 AM (GMT -7)
Thanks, John! This is great to see.
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 914
Posted 3/18/2020 11:51 AM (GMT -7)

Hugo18 said...
The best method of us Xeljanz patients to determine the risk we are at by continuing our medication may be from what other diseases that utilize the drug such as arthritis and psoriasis are finding. Xeljanz is much more in their community then the IBD world.


It is and is worth checking, although arthritis patients have other comorbidities like obesity so that can make it difficult to compare 1 on 1 (the same problem with assessing how high the thrombosis risk is in colitis patients)
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poopydoop
Veteran Member
Joined : Dec 2018
Posts : 914
Posted 3/19/2020 8:00 AM (GMT -7)
Daily update from covidibd.org. Still good news.

Updates and Data

3/19/2020 Update

Fourteen cases of COVID-19 have been reported to the registry so far:

United States: A 35 yo female with Crohn’s disease on budesonide. This patient was hospitalized but did not require intensive care or ventilator support.
Spain: A 24 yo female with ulcerative colitis on vedolizumab. This patient did not require hospitalization.
Switzerland: A 23 yo male with Crohn’s disease on Infliximab. The patient did not require hospitalization.
United Kingdom: A 64 yo male with ulcerative colitis on vedolizumab and mesalamine. The patient did not require hospitalization.
United States: A 53 yo female with Crohn’s disease on adalimumab and sirolimus. The patient was hospitalized but did not require intensive care or ventilator support.
United States: A female with ulcerative colitis on prednisone/prednisolone and tofacitinib. The patient did not require hospitalization.
Ireland: A 41 yo male with ulcerative colitis on mesalamine. The patient did not require hospitalization.
Spain: a 50 yo male with ulcerative colitis on tofacitinib. The patient did not require hospitalization.
United States: A male with Crohn’s disease on infliximab. The patient did not require hospitalization.
United States: A 30 yo male with ulcerative colitis on tofacitinib. The patient did not require hospitalization.
United States: A 41 yo male with ulcerative colitis on tofacitinib. The patient did not require hospitalization.
Spain: A 35 yo male with Crohn’s disease on infliximab. The patient did not require hospitalization.
Netherlands: A 52 yo female with ulcerative colitis on infliximab, mesalamine, and 6-mercaptopurine.The patient did not require hospitalization.
Italy: A 63 yo male with Crohn’s disease s/p ileocecal resection not on medication. The patient did not require hospitalization.

No mortalities have been reported to the registry to date.

The average number of days symptoms from COVID-19 among the above cases is 5 days.
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