Turkish IBD Organization's Position Statement on Inflammatory Bowel Disease Management Recommendations During COVID-19 Pandemic

The Impact of Inflammatory Bowel Diseases and Related Medications on COVID-19 Severity and Outcome: A Tertiary Referral Center Experience from Turkey

BACKGROUND

Coronavirus disease-2019 has become a serious pandemic, and still remains a risk despite vaccines that have been devel- oped. Among inflammatory bowel disease patients old age, inflammatory bowel disease activation, the existence of the comorbid dis- ease, and using steroids are known risk factors for severe coronavirus disease-2019. But there are different data for drugs other than corticosteroids used. The aims of the study are to evaluate the prevalence and risk factors of severe coronavirus disease-2019 and the effect of inflammatory bowel disease drugs on severe coronavirus disease-2019.

METHODS

In this study among 1195 inflammatory bowel disease patients, 130 patients who were found to be positive for severe acute respiratory syndrome coronavirus-2 between March 2020 and May 2021 were evaluated. Patients were divided into 3 groups as mild, moderate, and severe coronavirus disease-2019.

RESULTS

Among 130 patients, 91 (70%) had mild, 16 (12.3%) had moderate, and 23 (17.7%) had severe coronavirus disease-2019. Being 60 years of age or older (P = .009), having at least 1 comorbid disease (P = .002), and having active inflammatory bowel disease (P = .001) were factors that increased the risk for severe coronavirus disease-2019. The use of mesalazine (P = .35), biologic agents (P = .23), and corticosteroids (P = .42) did not increase the risk of severe coronavirus disease-2019. The use of azathioprine seemed to decrease the risk of severe disease with univariate regression analysis however the significance disappeared with multivariate analysis.

CONCLUSION

Older age, active inflammatory bowel disease, and existence of at least 1 comorbid disease are risk factors for severe coro- navirus disease-2019. However, drugs used in inflammatory bowel disease management do not increase the risk of severe coronavirus disease-2019. But due to the small number of patients, it is difficult to reach a definite conclusion about corticosteroids.

Bone Marrow Mesenchymal Stem Cells (BMSC) Carried with miR-338 Improve BMSC Homing in Intestinal Mucosa of Inflammatory Bowel Disease (IBD) Rats Through Increasing C-X-C Chemokine Receptor Type 4 (CXCR-4)

This study assessed whether bone marrow mesenchymal stem cells (BMSC) carried with miR-338 improve its homing in intestinal mucosa of IBD rats. Fifty SD rats were equally and randomly assigned into control set, model set, miR-338 set, CXCR-4 Inhibitor set and positive control set followed by analysis of miR-338 expression, body weight, DAI grade, pathological changes of distal colonic tissue, ultra-microstructure of intestinal epithelium, level of IL-8, IL-10, TGF-β1, VEGF, and CXCR4, as well as the relation between miR-338 and CXCR-4. miR-338 in decorated BMSC was significantly upregulated. Body weight in model set and CXCR-4 Inhibitor set was lowest followed by miR-338 set and positive control set. However, opposite results were obtained for DAI grade. IL-8 level was highest and IL-10 was lowest in model set and CXCR-4 Inhibitor set. The BMSC carried with miR-338 exerted recovery action on the intestinal mucosa of IBD rats and inhibited the activity of inflammatory cells. In conclusion, BMSC carried with miR-338 develops recovery action on the intestinal mucosa of IBD rats possibly through regulation of CXCR4, indicating that miR-338 might be a target for the treatment of IBD.