• COVID‐19
• atopic dermatitis
• dupilumab
• risk factor

• COVID-19
• SARS-CoV-2
• TNF-α-antagonists
• antibody
• inflammatory bowel disease
• vaccination

• Antibodies, Viral
• Antibody Formation
• COVID-19/immunology
• COVID-19 Vaccines/administration & dosage
• Crohn Disease/drug therapy
• Humans
• Immunoglobulin G
• Inflammatory Bowel Diseases/drug therapy
• Middle Aged
• Prospective Studies
• SARS-CoV-2
• Tumor Necrosis Factor Inhibitors/therapeutic use

• Rijksuniversiteit Groningen

• Biobetters
• CT-P13 SC
• Coronavirus disease 2019 (COVID-19)
• Inflammatory bowel disease
• Innovative biologics
• Real-world evidence
• Rheumatic diseases
• Subcutaneous infliximab
• Telemedicine

• Arthritis, Rheumatoid/drug therapy
• Biosimilar Pharmaceuticals/therapeutic use
• COVID-19
• Cross Infection
• Humans
• Inflammatory Bowel Diseases/drug therapy
• Infliximab/therapeutic use
• Treatment Outcome

• Celltrion Healthcare
• Medical University of Vienna

• COVID-19
• Crohn's disease
• inflammatory bowel disease
• lockdown
• ulcerative colitis

Although development of biologics has importantly improved the effectiveness in inducing and maintaining remission in inflammatory bowel disease (IBD), biologic therapies still have several limitations. Effective, low-cost drug therapy with good safety profile and compliance is therefore a substantial unmet medical need. A promising target for IBD treatment strategies are Janus kinase (JAK) inhibitors, which are small molecules that interact with cytokines implicated in pathogenesis of IBD. In contrast to monoclonal antibodies, which are able to block a single cytokine, JAK inhibitors have the potential to affect multiple cytokine-dependent immune pathways, which may improve the therapeutic response in some IBD patients. Tofacitinib, inhibiting signaling via different types of JAKs, has been already approved for ulcerative colitis, and several other small-molecule are still under investigation. However, one of the main concerns about using JAK inhibitors is the risk of thromboembolic events. Moreover, patients with COVID-19 appear to have an increased susceptibility for immunothrombosis. Therefore, thrombotic complications may become a serious limitation in the use of JAK inhibitors in the SARS-CoV-2 pandemic. As many questions about safety and efficacy of small molecules still remain unclear, in our review we present the current data regarding approved JAK inhibitors, as well as those in clinical development for the treatment of IBD.

• Crohn’s disease
• IBD
• JAK inhibitors
• small molecules
• ulcerative colitis

• ACE2
• COVID-19
• Crohn’s disease
• Infliximab
• Tocilizumab
• anti-TNF
• biologic drugs
• corticosteroids
• ulcerative colitis

During the coronavirus disease 2019 (COVID-19) pandemic, immunomodulatory therapies and hospital admission were suspected to increase the risk of infection. Nevertheless, patients with inflammatory bowel diseases (IBD) treated with intravenous (i.v.) biologics had to move to hospitals for drug infusion. We investigated the impact of hospitalisation in patients with IBD. We conducted a survey including consecutive IBD patients initially in clinical and biochemical remission treated with biologics at the end of the first lockdown period. Patients underwent the normally scheduled clinical visits, performed at hospital for i.v.-treated patients or at home for patients treated with s.c. drugs. We administered to all patients the Hospital Anxiety and Depression Scale (HADS) questionnaire and other 12 questions, specifically related to COVID-19 and its implications. A total of 189 IBD patients were recruited, 112 (59.3%) treated with i.v. drugs and 77 (40.7%) with s.c. ones. No relapses were recorded in either group (hospitalized vs. non-hospitalized, p = ns), as well as which, COVID-19 infections were not demonstrated in patients in contact with people with suspected symptoms or directly experiencing them. The total HADS score obtained by the sum of all items was also almost identical between groups (37.1 ± 2.8 vs. 37.2 ± 2.8; p = 0.98). In patients treated with i.v. drugs receiving a televisit (n = 17), the rate of satisfaction with telemedicine (58.8%) was significantly lower compared with those treated with s.c. drugs (94.8%; p < 0.0005). Our results suggest that hospitalisation during the COVID-19 outbreak does not increase the risk of COVID-19 infection as well as the risk of IBD relapse; moreover, the similar levels of anxiety in both groups could confirm that there is no need to convert patients from i.v. to s.c. therapy.

• COVID-19
• Crohn’s disease
• biologics
• clinical
• ulcerative colitis

Over the past decades, the treatment of inflammatory bowel diseases (IBD) has become more targeted, anticipating the use of immune-modifying therapies at an earlier stage. This top-down approach has been correlated with favorable short and long-term outcomes, but it has also brought with it concerns regarding potential infectious complications. This large IBD population treated with immune-modifying therapies, especially if combined, has an increased risk of severe infections, including opportunistic infections that are sustained by viral, bacterial, parasitic, and fungal agents. Viral infections have emerged as a focal safety concern in patients with IBD, representing a challenge for the clinician: they are often difficult to diagnose and are associated with significant morbidity and mortality. The first step is to improve effective preventive strategies, such as applying vaccination protocols, adopt adequate prophylaxis and educate patients about potential risk factors. Since viral infections in immunosuppressed patients may present atypical signs and symptoms, the challenges for the gastroenterologist are to suspect, recognize and diagnose such complications. Appropriate treatment of common viral infections allows us to minimize their impact on disease outcomes and patients’ lives. This practical review supports this standard of care to improve knowledge in this subject area.

• Inflammatory bowel diseases
• Viral infections
• Opportunistic infections
• Standard of care
• Crohn’s disease
• Ulcerative colitis

• Colitis
• Humans
• Immunocompromised Host
• Inflammatory Bowel Diseases/epidemiology
• Inflammatory Bowel Diseases/therapy
• Opportunistic Infections/diagnosis
• Opportunistic Infections/epidemiology
• Opportunistic Infections/prevention & control
• Virus Diseases/epidemiology

• COVID-19
• Endoscopy
• Gastroenterology practice
• Liver disease
• SARS-CoV-2

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic is a challenge for all participants in the healthcare system. At the beginning of the pandemic, many physicians asked themselves what risk their patients, especially those with chronic diseases, were exposed to. We present an overview of all patients with multiple sclerosis (MS) and SARS-CoV-2 infection published in the literature so far. In total, there are publications on 873 SARS-CoV-2 positive MS patients and information on the outcome can be given for 700 patients. With regard to the different disease modifying therapies (DMTs), by far the most cases were described under anti-CD20 treatment (n = 317). The mortality rate of all MS patients was 4% and a further 3% required invasive or non-invasive ventilation. When looking at the severe and fatal cases, it is particularly noticeable that patients without DMTs, with previous cardiovascular diseases, or with a severe degree of disability are at risk. Immunosuppressive therapy itself does not appear to be a substantial risk factor. Rather, it is reasonable to assume that the therapies could be protective, either directly, by mitigating the cytokine storm, or indirectly, by reducing the disease activity of MS.

• COVID-19
• SARS-CoV-2 pandemic
• disease-modifying therapies
• multiple sclerosis