Certain people are more likely to become very ill if they get COVID-19, the illness caused by the new coronavirus. That includes people who take medications that suppress, or weaken, their immune system.
Many things can lower your immunity, including chronic illness, recent surgery, or medication. Any of those things might apply to you. Some, but not all, Crohn’s drugs suppress your body’s immune response. So far, experts haven’t done any specific research on COVID-19 and people with Crohn’s.
Doctors are still learning about the new coronavirus. But there’s already some expert advice for people with inflammatory bowel diseases such as Crohn’s.
First things first: It’s especially important for you to follow guidelines to stay home, avoid sick people, keep your distance from people who seem healthy but you don’t live with, wear a mask in public, wash your hands often, clean items you use often, wear a face mask when you’re in public places, and try not to touch your face.
Get vaccinated if it becomes available to you. On top of that, you’ll also want answers to these questions.
Should I Stick With Treatment?
Don’t stop any of your medications. If you’re concerned about them, consult your doctor. Now more than ever, you want to avoid any flares that could send you to the hospital.
Several different types of medications treat Crohn’s, and they act on your body in different ways.
These drugs don’t affect your immune system:
- Balsalazide (Colazal, Giazo)
- Mesalamine (Apriso, Asacol, Delzicol, Lialda, Pentasa)
- Olsalazine (Dipentum)
- Sulfasalazine (Azulfidine)
Immunomodulator drugs do affect your immune system. They include:
- 6-mercaptopurine (Purinethol, Purixan)
- Azathioprine (Azasan, Imuran)
- Cyclosporine (Gengraf, Neoral, Sandimmune)
- Methotrexate (Rheumatrex, Trexall)
These drugs stay in your body for months. If you were to stop taking them now (which, again, you shouldn’t do on your own), you’d lose the benefit against Crohn’s without affecting how you might respond to COVID-19.
Biologic and biosimilar drugs also suppress the immune system. These include:
- Adalimumab (Humira) and its biosimilars Amgevita, Cyltezo, and Hyrimoz
- Certolizumab pegol (Cimzia)
- Golimumab (Simponi)
- Infliximab (Remicade) and its biosimilars Inflectra, IXIFI, Renflexis
- Natalizumab (Tysabri)
- Vedolizumab (Entyvio)
- Ustekinumab (Stelara)
If you use these medicines, experts recommend you take extra precautions. That might include limiting travel and avoiding large gatherings, if they aren’t already banned in your area.
What About Steroids?
If you take steroids (prednisone, prednisolone), you may want to talk to your doctor about lowering the dose or switching drugs. Tapering off steroids is always recommended, but it may be even more important now. Although much about COVID-19 is unclear, studies of Chinese patients suggest a possible link between steroids and more severe complications. But the reason for that isn’t known yet.
Can I Get My Infusion?
If you get your treatments as infusions (IVs), you may be worried about going to your doctor to receive them. Here are options:
- Try to schedule for a time when few people are in the facility to limit being around others.
- Ask about at-home infusions. But keep in mind that infusion centers are taking extra precautions to ensure patient safety because many people have no choice but to go in.
If your doctor has prescribed an infusion drug that you haven’t started taking yet, you might want to ask your doctor if it makes sense to switch to a drug that you can inject at home.
What About COVID-19 and My Gut?
If you were to get COVID-19, would it cause a Crohn’s flare? Doctors don’t have evidence of that, but there’s not much data on this yet.
Do I Need to Boost Supplies of Medicines?
If officials in your area tell everyone to stay at home, your prescriptions should be part of your disaster plan. Check with your insurance provider about refill rules. Shortages of common Crohn’s medications haven’t been a problem, and the FDA is tracking supplies.
What About Toilet Paper?
Toilet paper has been in high demand, and that can be especially stressful when you have a condition like Crohn’s. If you run out, ask friends or family if they can share some of their reserves. If there is absolutely none to be found anywhere, consider these last-resort options:
- Paper towels or napkins, although you’ll need to throw them in the trash, not the toilet. Putting a little bit of lotion on the paper before you use it will help protect your skin.
- Wipes made for this purpose, although you shouldn’t flush these, either.
- Soft washcloths, which you should treat like cloth diapers. Rinse solids off in the toilet, then launder in hot water to sanitize.
You could also shower to clean yourself after a bowel movement.
How Can I Deal With Stress?
If you’re more anxious now, given everything that’s going on, you’re not alone. Since stress can trigger flares, it’s important to take care of your emotions. Here are some suggestions:
- Take breaks from the news.
- Have a plan for how you will get groceries and other supplies if you need to stay home.
- If you have a therapist, see if they’re doing online or phone appointments.
- Check in with your doctor if you have specific health concerns.
- Look to friends, family, or other people with Crohn’s online for support.
- Get some exercise. It’s a proven way to tame stress.
- Find ways to do activities you enjoy. Get outside if you can.