News

Does IBD Increase Your Risk of COVID-19?

For people who live with inflammatory bowel disease (IBD), there may be special concerns regarding risks for the novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19, because of medications, prior surgery, or immunosuppression. However, IBD itself is not currently thought to be a risk factor for COVID-19.

The international IBD community, through the International Organization for the Study of IBD (IOIBD) and other non-profit organizations, is sharing knowledge and experience regarding how IBD patients should respond to the pandemic and what precautions should be taken. There are guidelines in place that help both healthcare providers and patients understand how the management of IBD should, and should not, change when COVID-19 becomes a factor.

Managing IBD During the Pandemic

People with IBD are concerned about continuing their medications when there is a risk of developing COVID-19. This is because some IBD medications are used to dampen the immune system to prevent inflammation in and around the digestive system, making you more susceptible to infections.

IBD experts agree it is critical for people with IBD to continue to receive their medications as scheduled and stay in remission. This is because preventing a flare-up of your IBD can help you avoid trips to the doctor during the pandemic.

Untreated Crohn’s disease or ulcerative colitis could lead to more serious health problems that can go on for a long period of time, or even be permanent, and cause a greater need to receive healthcare services. The more there is a need to receive treatment at a hospital, the more likely it is that you may be in contact with people who are positive for COVID-19. 

Receiving Medication Infusions

Some IBD medications are given by IV, which usually means traveling to a doctor’s office, clinic, hospital, or infusion center to receive the drug. Besides the concern about the medication itself suppressing the immune system, patients have concerns about being at an infusion clinic and therefore in contact with other people.

The IOIBD agrees that going to an infusion center is the best choice, as long as there are measures put in place. Some of the things that infusion centers should be doing include:

  • Screening patients for possible exposure to COVID-19 (such as with a questionnaire)
  • Screening patients for symptoms of COVID-19 (such as cough or fever)
  • Keeping chairs at least 6 feet apart so patients can maintain physical distancing
  • Use of gloves and masks by all providers
  • Providing masks and gloves to all patients
  • Taking other steps as needed, including administering COVID-19 testing, to protect staff and patients

IBD and Immunosuppression

While you may be particularly worried about protecting and bolstering your immune system during COVID-19, know that Crohn’s disease, ulcerative colitis, and indeterminate colitis do not inherently cause immunosuppression. Rather, it's certain medications that can cause immunosuppression.

People receiving the following drugs are not considered to be immunosuppressed:

  • 5-aminosalicylic acid (5-ASA) drugs
    • Colazal
    • Asacol
    • Apriso
    • Lialda
    • Pentasa
    • Dipentum
    • Azulfidine (sulfasalazine)
  • Non-systemic glucocorticosteroids

People living with IBD who are receiving certain types of medications are considered to be immunosuppressed. Some of these medications include:

Because they stay in the body for a long period of time, stopping immunosuppressive medications will not have an immediate effect on the immune system, so patients are encouraged to keep taking them.

People with IBD who have had surgery to treat their disease and who currently live with an ostomy (ileostomy or colostomy) or who have a j-pouch (ileal pouch anal-anastomosis, or IPAA) are also not considered to be immunosuppressed. This means that those who have an ostomy or a j-pouch and are not receiving any of the medications that affect the immune system are not considered to be at greater risk of developing COVID-19.

People With IBD Diagnosed With COVID-19

If a patient is diagnosed with COVID-19, their doctor may make the call to stop IBD medications. The IOIBD recommends restarting medication 14 days after the positive SARS-CoV-2 test, or after 2 nasal swabs are negative for SRS-CoV-2. If a patient has symptoms of COVID-19 and their doctor asks them to stop taking IBD medications, the IOIBD says they can restart again after the symptoms resolve. 

A Word From Verywell

While the data is still being collected, it currently does not seem that having IBD puts patients at a greater risk of either contracting COVID-19 or becoming seriously ill. However, taking a medication that suppresses the immune system may increase the risk, although it’s not yet known by how much. People with IBD are urged to continue on their treatment plan and to practice physical distancing.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Rubin DT, Feuerstein JD, Wang AY, Cohen RD. AGA clinical practice update on management of inflammatory bowel disease during the COVID-19 pandemic: Expert commentary. Gastroenterology. 10 Apr 2020. [Epub ahead of print]. doi:10.1053/j.gastro.2020.04.012

  2. IOIBD Taskforce: Dotan I, Panaccione R, Kaplan GG, O’Morain C, Lindsay J, Abreu MT. IOIBD recommendations: Best practice guidance for adult infusion centers during the COVID 19 pandemic. International Organization for the Study of IBD. 17 Apr 2020. 

  3. Rubin DT, Abreu MT, Rai V, Siegel CA; International Organization for the Study of Inflammatory Bowel Disease. Management of patients with Crohn's disease and ulcerative colitis during the COVID-19 pandemic: Results of an international meeting. Gastroenterology. 2020 Apr 6. pii: S0016-5085(20)30465-0. doi:10.1053/j.gastro.2020.04.002 [Epub ahead of print]