Research gives hope to those highly susceptible to virus

A hospital in Wuhan that used strict measures to prevent inflammatory bowel disease, or IBD, patients from contracting the novel coronavirus could provide a model for health services globally.

A study, led by researchers at Wuhan University and the University of Melbourne in Australia, outlines a model to prevent COVID-19 in IBD patients and possibly those with other high-risk conditions.

“Our work has been aimed at highlighting the importance of … preventing coronavirus infections among patients using immune suppressive drugs,” said Dr Nik Ding, University of Melbourne researcher and gastroenterologist at St Vincent’s Hospital, Melbourne.

The study, “Prevention of COVID19 in patients with inflammatory bowel disease in Wuhan, China”, was published in The Lancet Gastroenterology and Hepatology journal on April 17.

Ding worked on the project with Wuhan University academics and several departments of Wuhan University’s Renmin Hospital.

IBD is a disorder mainly associated with Western societies, but Ding said this is changing, “especially as Asian dietary habits change and they adopt Western-style diets”.

And he said collaboration in this area of research has been significant, even though the numbers with IBD in China are still relatively small.

Of the 318 patients with IBD, 204 had ulcerative colitis and 114 had Crohn’s disease. More than twothirds lived and worked near Huanan Seafood Supermarket.

In January, patients were asked to withhold their immunosuppressive therapies due to the potential high risk of COVID-19 infection, in accordance with national Chinese Society of Gastroenterology guidelines.

A range of prevention measures were introduced, and regular information and instructional alerts were sent to the patients’ online IBD groups via the social media platform WeChat.

The measures included single hospital rooms, advice to stay at home if possible, encouraging the use of N95 masks for those who had recent treatment with biologics and immunosuppressants, and keeping in contact with the IBD team every day.

Patients were also informed about self-prevention actions such as avoiding public places and selfisolating and improving personal protective healthcare practices, including hand hygiene and wearing masks.

Ding said the work done in caring for IBD patients at what was a COVID-19 epicenter has provided a model that could be translated anywhere in the world, particularly in densely populated cities.

“This hospital has taken it to the next level by communicating directly through popular social media channels. They also protected the patients by asking their loved ones to follow the same advice. Taking extra precautions definitely can help.”

On Feb 10 the patients were sent questionnaires about coronavirus exposure, risk factors and prevention measures.

Most heeded the advice. None of the 318 patients reported concerning respiratory symptoms and none tested positive for COVID-19 by March 30, despite 29 having tests due to possible symptoms. Some had required hospital treatment for IBD complications.

The researchers believe the experiences reported could provide a model of care to prevent COVID-19 in patients with IBD.