Certain UC medications could make COVID-19 more dangerous.
COVID-19 is a serious virus that has affected millions of individuals around the world, but it hasn’t affected everyone equally. People with underlying conditions, such as ulcerative colitis, may have additional risk factors. While ulcerative colitis makes daily life difficult, coupling that with a COVID-19 infection can be dangerous.
Risk Factors for COVID-19 with Ulcerative Colitis
The main factor that puts ulcerative colitis patients at risk is the kind of medication they take. Immunosuppressants are medicines that weaken the immune system to reduce disease symptoms. There are different kinds of medications that can treat UC by suppressing the immune system. This means their body may have a weakened defense system that won’t be able to fight off infections.
At the start of the pandemic, it wasn’t clear if people with ulcerative colitis had an increased risk of getting or dying from COVID-19. However, it’s now known that different UC treatments affect COVID-19 risk differently.
What Are Glucocorticoids?
Glucocorticoids are a type of steroid that help reduce inflammation in the body. Doctors prescribe glucocorticoids when a patient is having a flare, or a worsening of symptoms. This can help relieve symptoms and get UC back under control.
However, glucocorticoids suppress the immune system, and as a result can increase the risk of severe COVID-19 infection. However, stopping glucocorticoids can cause or worsen a flare, which also isn’t good for COVID-19 risk. As a result, patients who are on glucocorticoids and receive a diagnosis of COVID-19 should talk with their doctor about the pros and cons of continuing this steroid therapy.
What Is Anti-TNF Therapy?
Anti-TNF (tumor necrosis factor) therapies are biologics that target the part of the immune system that causes ulcerative colitis symptoms. Instead of suppressing the entire immune system, they only target a very specific part of the immune system. As a result, patients who are on anti-TNF therapies do not appear to have an increased risk of COVID-19 and its complications.
In fact, it seems that anti-TNF therapies can actually be protective against COVID-19. This is in part because taking medicines that keep your ulcerative colitis under control help prevent the need for glucocorticoids. When there’s no flare, there’s no need for steroid treatment.
COVID-19 Prevention If You Have Ulcerative Colitis
In order to minimize your risk for COVID-19, you should follow some steps for prevention. These can involve:
- Social distancing
- Masks when needed
- Following your treatment plan as prescribed by your doctor
If you have questions about the risks of taking your ulcerative colitis medicines during the pandemic, talk to your doctor. Having an open and honest conversation can help quell any concerns or fears you may have.
Dr. Kayal is a gastroenterologist at Icahn School of Medicine at Mount Sinai.
- COVID-19 (coronavirus): what IBD patients should know. Crohn's & Colitis Foundation, 2021. (Accessed on July 22, 2021)
- COVID-19: issues related to gastrointestinal disease in adults. Waltham, MA: UpToDate, 2021. (Accessed on July 22, 2021)
- IBD patient guidance. Crohn's & Colitis Foundation, 2021. (Accessed on July 22, 2021)
- Management of moderate to severe ulcerative colitis in adults. Waltham, MA: UpToDate, 2021. (Accessed on July 22, 2021)