COVID 19 anything new?

My dear patients !

I am not writing about top secret data here, which are only available for certain people. But I am writing about what is available under the link https://covidibd.org/updates-and-data for everyone. There you can read the (almost worldwide) numbers of patients with inflammatory bowel disease infected with COVID 19.

As you know I am a friend oft objective information. And I would include the numbers from the link to that. Yet I was not quite sure  wether I should share it.

Because I recognized myself that you can have a – quite objective – look at the numbers and take notice of them.  But what is of interest for you and for me is  the question: what do these numbers tell me about my risk or the risk of my patients with inflammatory bowel disease of infection and even severe infection with COVID 19 ?

What is the meaning of those numbers?

I look at the numbers every couple of days and always think: aren`t that many.

Which is true. In Germany we have more than 400.000 patients with inflammatory bowel disease, numbers in the US are even higher (> 1 Mio.).

And if you look at the number of COVID-19 positive patients with inflammatory bowel disease against this background – aren´t that many !

Of course there is a latency to the report of patients. Of course never all the patients find their way into the statistics. But that doesn`t change that much: there are not so many IBD patients with Crohn`s disease or ulcerative colitis infected with Corona virus

And I think numbers are representative since patients with inflammatory bowel disease belong to a group of patients who rather see doctors more frequently or at least on a frequent basis. Or have contact to doctors offices or outpatient clinics.

As for me…since March I have seen quite a few of my IBD patients. The ones I didn`t see I contacted by telephone (and continue doing that).

And even when I just signed a prescription my colleagues handing me the receipt to sign and said somerthing like: Mr X or Mrs y called, she needs a new prescription for …whatever. He or she is doing alright.

So I doubt that – at least on Germany – a patient with Crohn`s disease or ulcerative colitis gets sick without anybody from the medical team (doctor, IBD nurse) recognizing  it.

I will write what went through my mind while looking at the numbers:

  1. The all over number of IBD patients tested postive for Corona / COVID 19 is not high. For example germany: 26 recorded IBD patients having a COVID 19 infection are not many.

    I think the community of doctors in germany who take care of patients with Crohn`s disease or ulcerative colitis knows this link and knows that we are supposed to register our IBD patients in case of COVID19 infection. And I think they would do it.

    And even the 321 COVID-19 patients with inflammatory bowel disease reported in the US – most of you know the numbers of overall infections in the country from the news, it is acutally unavoidable to know the numbers  – are not that many.
  1. The majority of patients can get outpatinet reatment and doesn`t even have to go into the hospital. Except … (3!)

  2. It shows that also for the patients with inflammatory bowel disease it is valid: from a certain age on (and I think it is also the age of 65 years here) there is an increased risk for a severe course of COVID 19

    And at that point the frequency of necessity of admission to hospital is of course changing as well in terms that patients with inflammatory bowel disease in the age of 65 and older need to be treated in a hospital in case of COVID 19 more often
  1. Regarding the stadium or the activity of the disease: most patients with inflammatory bowel disease and reported COVID 19 infection are in remission – that´s of course the patients on therapy and presumable immunosuppressive therapy.

    What does that tell us ?

    Well I think it does definitely not suggest: patients with Crohn`s disease or ulcerative colitis  under therapy are on relevant high risk for infection with COVID-19. Numbers are to low for that. Just in my consultation hour I have far more patients on immunosuppressive therapy than IBD patients in germany with COVID 19 infection. And until today I do not have any Corona-positiv patient.
  1. Regarding therapy in terms of which therapy patients with inflammatory bowel disease and recorded COVID 19 infection are on.

    I would definetly not draw any conclusion from that.

    Because numbers tell us what therapy the IBD patiens with COVID 19 are on but they do not tell us how many patients on a certain therapy get infected with COVID 19.

    For example: if there are 5 patients on steroids and 4 of them are infected with COVID 19, that is proportional more (actually 80%) than having 500 patients on TNF alpha antibody therapy and having 50 infected from these (actually 10%). Yet the absolute number 50 is much higher than 4 at the first glance. You get the point, right ?

What does that tell us?

And at that point you recognize that these numbers are interesting in a way , but that the conclusions we can draw are limited.

And still I thought it might be interesting for you and therefor wanted to share the link.

It is still valid: be carefull, stick to the general recommendations:

keep distance, wash your hands, wear a mask and if you are on immunosuppressive therapy wear a FFP2 mask and make sure, people you have contact with wear masks as well.

Which means: be carefull and take care of yourself  ? – definetly yes ! Be afraid ? Absolutely no !

So again : take care !

Best regards,

Dr. Susanne Weyrauch

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