COVID-19: biologic and immunosuppressive therapy in gastroenterology and hepatology.
Nat Rev Gastroenterol Hepatol
; 18(10): 705-715, 2021 10.
Article
in English
| MEDLINE | ID: covidwho-1287810
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health crisis causing major challenges for clinical care in patients with gastrointestinal diseases. Although triggering of anti-viral immune responses is essential for clearance of infection, some patients have severe lung inflammation and multiorgan failure due to marked immune cell dysregulation and cytokine storm syndrome. Importantly, the activation of cytotoxic follicular helper T cells and a reduction of regulatory T cells have a crucial, negative prognostic role. These findings lead to the question of whether immunosuppressive and biologic therapies for gastrointestinal diseases affect the incidence or prognosis of COVID-19 and, thus, whether they should be adjusted to prevent or affect the course of the disease. In this Review, data on the use of such therapies are discussed with a primary focus on inflammatory bowel disease, autoimmune hepatitis and liver transplantation. In particular, the roles of corticosteroids, classic immunosuppressive agents (such as thiopurines and mycophenolate mofetil), small molecules (such as Janus kinase (JAK) inhibitors), and biologic agents (such as tumour necrosis factor (TNF) blockers, vedolizumab and ustekinumab) are reviewed. Finally, the use of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines for the prevention of infection in patients with gastrointestinal diseases and concomitant immunosuppressive or biologic therapy will be discussed.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Biological Factors
/
Immunocompromised Host
/
Cytokine Release Syndrome
/
Gastrointestinal Diseases
/
COVID-19
/
Immunosuppressive Agents
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Humans
Language:
English
Journal:
Nat Rev Gastroenterol Hepatol
Journal subject:
Gastroenterology
Year:
2021
Document Type:
Article
Affiliation country:
S41575-021-00480-y
Similar
MEDLINE
...
LILACS
LIS