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Brief update on #COVID19 for inflammatory bowel disease (#IBD) patients as of 9 March 2020.
See the updated #IOIBD COVID19 recommendations on the ioibd.org website.
1/
The #IOIBD site now includes this statement: "It is prudent that IBD patients on immunosuppressants and/or biologics limit unnecessary travel and large gatherings." (and spells out these therapies) However, please know that we still recommend staying on treatment. Read on. 🔽
2/
In a global email exchange among #IBD experts over the last few days, the consistent recommendation is to stay on therapy for IBD, recognizing that IBD relapse or needing steroids is higher risk for the patient. There are similar recommendations from rheumatology experts.
3/
There is worldwide communication among IBD experts, and there are not reports of IBD patients with COVID (yet), but we are being vigilant. (This includes communications from our wonderful colleagues in China, Hong Kong and Italy.)
4/
**Hand hygiene and great care for avoiding other #COVID19 exposures remain the most important measures for individuals.**

NEXT: #IOIBD is having a global conference call to discuss specific scenarios and update our recommendations soon.

Stay safe, stay well everyone.
4/4 fin
@gilkaplan @bruce_sands1 @UmaMahadevanIBD @DrCoreySiegel @ibddocmaria @Siew_C_Ng @AshwinMDIBD @doc_ibd @guthealthmd @ibddoctor @silvio_silvio75 @RPanaccione @JeanFredericCo1 @ryanungaro @JamesLewisGIEpi @DrsMeena @CrohnsColitisFn @CrohnsColitisUK @AmCollegeGastro @AmerGastroAssn
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#COVID19 #IBD #IOIBD

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David T. Rubin, MD
@IBDMD
A Tweetorial on #coronavirus (and #IBD):
Coronaviruses are a family of viruses that can cause illness from the common cold to more severe diseases. The novel strain of #coronavirus named #SARSCoV2 was first detected in Wuhan, China and causes coronavirus disease #COVID19. 1/
How is #coronavirus transmitted?
Via respiratory droplets produced when an infected person sneezes or coughs and can infect people in close contact (within 6 feet). Touching contaminated surfaces before touching your eyes/nose/mouth might also lead to infection. 2/
How does #COVID19 compare with seasonal #influenza?
Both are infectious respiratory illnesses that present with symptoms such as fever, cough, and shortness of breath. Both can lead to serious illness especially in older people and those with prior medical conditions. 3/
Read 9 tweets
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David T. Rubin, MD
@IBDMD
We are developing and studying biosensors as tools to predict #IBD activity (a thread in 5 parts).
In press: we show the correlation between standard instruments of PAIN, QUALITY of LIFE and SLEEP QUALITY and simplified Visual Analog Scales. #RubinLab 1/ academic.oup.com/crohnscolitis3… ImageImage
We demonstrated high correlation between daily single "click" and "swipe" rating by a patient of their global health and sleep quality and the standardized validated and more cumbersome survey instruments that require recall of prior days/weeks. #RubinLab @UChicagoIBD 2/
One finding: patient-reported quality of life is very related to pain using the Wong-Baker Faces of Pain scale (WBS). Red dots are patients who also have active #IBD, black are those in remission. We are building pain assessment into our future dz monitoring tools. 3/ Image
Read 5 tweets

Related threads

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Avraham Z. Cooper, MD
@AvrahamCooperMD
1/
 Fingernail clubbing is associated with many systemic diseases, from lung cancer to TB to inflammatory bowel disease.

Why would such different diseases all manifest with clubbing?

The answer is surprisingly simple and elegant.

#medtwitter #tweetorial
2/
 To begin, let's define fingernail clubbing:

💡 Clubbing = increased curvature of the nail plate
💡 Normal nails are concave at ~160 deg; clubbed nails are convex at >180 deg
💡 The Schamroth sign (loss of the window between opposed nails) is suggestive
3/
 Clubbing was actually first described 2,500 years ago by Hippocrates, making it perhaps the oldest physical finding in medicine.

The term "clubbing" was coined in 1862 by Armand Trousseau (yes, that Trousseau) after observing TB patients.

ncbi.nlm.nih.gov/books/NBK366/
Read 18 tweets
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Peter Higgins
@ibddoctor
Questions today about the risk of coronavirus nCoV-19 in #IBD patients on immunosuppressive therapies. We don't know a lot, as this is quite new. The most up-to-date information can be found at the CDC website cdc.gov/coronavirus/20…
It appears to be spread by respiratory droplets, generally when you inhale droplets from a cough or sneeze from a nearby person (usually within 6 feet). Do #IBD patients have increased risk for this respiratory virus?
By analogy to influenza, another respiratory virus spread by droplets that we know more about, #IBD patients have about a 50% increased risk of influenza. This risk goes up by about 20% more if you are on steroids. ncbi.nlm.nih.gov/pubmed/30020478
Read 8 tweets
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Josh Hall-rdnewsNOW 🇨🇦🌈
@vancan19
INFUSION #42 THREAD: Here's my girl & I waiting for the school 🛎 to ring this morning.

I wouldn't be able to take her to school if not for the miracle drug I consider REMICADE to be.

In 2015, for the better part of 6 months, I spent 3+ hours in the bathroom each morning.
It was HELL. She wasn't in school yet, of course, but reality is that I may not be able to do this by the end of 2020.

That's because I'm being forced to switch to the bioSIMILAR version of my medication (a biologic), which I receive every 4-6 wks to treat my colitis (IBD).
I was diagnosed in 2008 (had symptoms summer '07). I was on at least 3 different meds over 8 years, and on a 🎢 health-wise until a doctor had the sense to finally put me on Remicade.

My disease has been stable/in remission ever since.
Read 19 tweets
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Roseistoast
@RoseePink
The UCP does NOT understand how devastating removing brand name biologics from the list of covered drugs could be. Let me explain..edmonton.citynews.ca/2019/11/18/cro…
Biological drugs are very expensive. They are genetically engineered antibodies that target specific molecules in our bodies that contribute to a disease process (like cancer, inflammation). They do not always just block the molecule from engaging it’s receptor.
Sometimes they have other actions (like inducing apoptosis/cell death) or activating receptors, or signaling other cells to eat the molecule/cell that the antibody binds to. That means that depending on how the antibody was originally designed, the therapeutic effect is different
Read 10 tweets
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Birmingham Health Partners
@BHPComms
Not sure what to expect at the 2019 BHP Research Showcase? Our free public event will be held at @qehbham on Fri 17 May, where you can get hands-on with our health research. If you want to #BePartOfResearch, take a look through our exhibitor info THREAD > birminghamhealthpartners.co.uk/research-showc…
Our #cardiology stand will focus on current studies that are changing & saving the lives of our patients. Our cardiology team is one of the largest in the UK and works closely with @ICVS_UoB to treat every type of #heartdisease
#BePartOfResearch
.@UmbrellaHealth is the home of #sexualhealth services for Brum & Solihull. They'll be here with interactive displays highlighting research into #HIV and #STIs, including #antimicrobialresistance and bacterial vaginosis >> umbrellahealth.co.uk
#BePartOfResearch
Read 23 tweets
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Forrest Maready
@forrestmaready
1. If you want to understand what causes Crohn’s disease, ulcerative colitis, or actually many other chronic illnesses, and why most medicine doesn’t seem to treat it, I want to explain what may be happening. (thread)
#crohnsdisease #ulcerativecolitis #ibd #chronicillness #crohns
2. This hypothesis is a collaboration between my wife and I, and is based on longstanding research + some new studies that have come out in the last year or so.
3. Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract. Like many of the other inflammatory bowel diseases, it can be a debilitating illness that makes life a living hell. If it gets bad enough, it can kill.
Read 75 tweets

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