Does IBD Increase Your Risk of COVID-19?

People who have inflammatory bowel disease (IBD), may have special concerns regarding the novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19. These risks relate to 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, and guidelines are emerging regarding COVID-19 precautions, treatments, and vaccination for people with IBD.

Managing IBD During the Pandemic

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

Untreated Crohn’s disease or ulcerative colitis could lead to serious health problems that can include nutritional deficits due to malabsorption, or intestinal complications that could require surgery.

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 suppressing the immune system, patients have concerns about being at an infusion clinic and 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 precautions taken at infusion centers 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)
• Entocort, a non-systemic glucocorticoid
• Uceris

The following medications used for treating IBD will suppress the immune system:

• Corticosteroids (like prednisone)
• Imuran
• Methotrexate
• Biologics
  Remicade
• Humira
• Cimzia
• Stelara
• Xeljanz

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

Vaccination

It is generally recommended that people who have IBD receive the vaccine to protect against COVID-19. There's some evidence that having IBD may affect your immune response to the vaccine, and that immunity can be more effective after a booster.

People With IBD Diagnosed With COVID-19

If you are diagnosed with COVID-19, your doctor may make the call to stop your 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 you have symptoms of COVID-19 and your doctor tells you to stop taking IBD medications, the IOIBD says you can restart again after the symptoms resolve. 

These recommendations do not supersede your doctor's advice. You might have more individualized instructions—depending on your overall health, the severity of your IBD, and the specific medications you're taking.

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 from the virus. 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 and all standard COVID-19 precautions.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.