COVID-19 and Inflammatory Bowel Diseases: Risk Assessment, Shared Molecular Pathways, and Therapeutic Challenges

Iolanda Valentina Popa; Mircea Diculescu; Cătălina Mihai; Cristina Cijevschi-Prelipcean; Alexandru Burlacu

doi:10.1155/2020/1918035

COVID-19 and Inflammatory Bowel Diseases: Risk Assessment, Shared Molecular Pathways, and Therapeutic Challenges

Gastroenterol Res Pract. 2020 Jul 10:2020:1918035. doi: 10.1155/2020/1918035. eCollection 2020.

Authors

Iolanda Valentina Popa¹, Mircea Diculescu², Cătălina Mihai¹, Cristina Cijevschi-Prelipcean¹, Alexandru Burlacu³

Affiliations

¹ Institute of Gastroenterology and Hepatology Iași, Romania and ''Grigore T. Popa'', University of Medicine, Iasi, Romania.
² Department of Gastroenterology Fundeni Clinical Institute, Bucharest, Romania and 'Carol Davila', University of Medicine and Pharmacy, Bucharest, Romania.
³ Department of Interventional Cardiology-Cardiovascular Diseases Institute and 'Grigore T. Popa', University of Medicine, Iasi, Romania.

Abstract

Background: The novel coronavirus SARS-CoV-2 causing COVID-19 disease is yielding a global outbreak with severe threats to public health. In this paper, we aimed at reviewing the current knowledge about COVID-19 infectious risk status in inflammatory bowel disease (IBD) patients requiring immunosuppressive medication. We also focused on several molecular insights that could explain why IBD patients appear not to have higher risks of infection and worse outcomes in COVID-19 than the general population in an attempt to provide scientific support for safer decisions in IBD patient care.

Methods: PubMed electronic database was interrogated for relevant articles involving data about common molecular pathways and shared treatment strategies between SARS-CoV-2, SARS-CoV-1, MERS-CoV, and inflammatory bowel diseases. Besides, Neural Covidex, an artificial intelligence tool, was used to answer queries about pathogenic coronaviruses and possible IBD interactions using the COVID-19 Open Research Dataset (CORD-19). Discussions. Few molecular and therapeutic interactions between IBD and pathogenic coronaviruses were explored. First, we showed how the activity of soluble angiotensin-converting enzyme 2, CD209L other receptors, and phosphorylated α subunit of eukaryotic translation initiation factor 2 might exert protective impact in IBD in case of coronavirus infection. Second, IBD medication was discussed in the context of possible beneficial effects on COVID-19 pathogeny, including "cytokine storm" prevention and treatment, immunomodulation, interferon signaling blocking, and viral endocytosis inhibition.

Conclusions: Using the current understanding of SARS-CoV-2 as well as other pathogenic coronaviruses immunopathology, we showed why IBD patients should not be considered at an increased risk of infection or more severe outcomes. Whether our findings are entirely applicable to the pathogenesis, disease susceptibility, and treatment management of SARS-CoV-2 infection in IBD must be further explored.

Publication types

Review