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Do you have questions about COVID-19 and the impact it has on people affected by Crohn's and colitis? Scroll down to browse commonly asked questions and get answers from our COVID-19 Task force and other IBD experts. 

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  • COVID-19 is a new type of coronavirus that is infecting people around the world. Coronaviruses are very common, and typically cause coughs and colds. This form of coronavirus emerged in late 2019. The novel virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease that the virus causes is called COrona VIrus Disease-2019 (COVID-19).

    Symptoms typically include mild cold or flu-like symptoms such as fever and a new cough. Most people recover from the illness at home. However, some individuals experience more serious respiratory symptoms (pneumonia) develop which might require hospitalization, the need for mechanical ventilation, or even result in death. More information is available from the Government of Canada.

    On March 11, 2020, the World Health Organization (WHO) declared that COVID-19 was a pandemic. This means it is infecting people around the world in a way that is difficult to control.

    Watch the 2-minute video below to learn from an expert gastroenterologist about what coronaviruses are, including COVID-19.


    For more information about COVID-19 symptoms and outcomes, please click here

  • Individuals with IBD likely fall into one of three risk for infection and complications of COVID-19 groups:
    • High Risk: Over the age of 65 years OR under 65 years AND either moderate or severely flaring, using high doses of prednisone, or moderate to severe malnutrition
    • Medium Risk: Under the age of 65 years and immunocompromised with an immunosuppressive or biologic
    • Low Risk (i.e. same as the general population): Under the age of 65, IBD is in remission, and not immunocompromised
    To find out your level risk and what you should do, please click here.
  • If you think that you may have COVID-19, isolate yourself within your home as quickly as possible and speak to your healthcare provider or local public health authority by telephone. Be sure to tell your local public health authority that you have IBD, and if you are on immunosuppressant medications. You can also take a self-assessment tool available from various provinces.

    Do not go to your doctor’s office or the emergency department (unless it is an emergency). If it is an emergency, phone 911 and inform them of your symptoms, travel history, that you have IBD, and that you are taking immunosuppressive medications.
  • Speak to your gastroenterologist right away if you have tested positive for COVID-19.

    Please remain isolated. Refer to your local public health department for information on what to do.

    Medications that are not immunosuppressive should be continued. The following IBD treatments do not suppress your immune system:

    • 5- aminosalicylates (5-ASA's): mesalamine, mesalazine (Asacol®, Mezavant®, Pentasa®, Salofalk®), sulfasalazine (Salazopyrin®)

    • Locally acting steroids: budesonide (Entocort®), budesonide MMX (Cortiment®), steroid enemas

    • Enteral nutrition (formula feeds) or dietary therapies

    • Probiotics

    If you are using immunosuppressive medications (including biologics), you should temporarily stop your medications and speak to your doctor immediately. Immunosuppressive and biologic medications include:

    • Steroids: prednisone (Deltasone), methylprednisolone, hydrocortisone (Hydrocort, Cortate)

    • Immunomodulators: azathioprine (Imuran), 6-mercaptopurine (Purinethol), methotrexate

    • Anti-TNF biologics: infliximab (Remicade®, Inflectra®, RenflexisTM), adalimumab (Humira®), golimumab (Simponi®)

    • Anti-IL12/23 biologics: ustekinumab (Stelara®)

    • Anti-leukocyte migration biologics: vedolizumab (Entyvio®)

    • JAK inhibitor small molecules: tofacitinib (Xeljanz®)

    NEVER stop prednisone suddenly - speak to your doctor first. We are not yet certain whether it is safe to continue immunosuppressive medications during a COVID-19 infection. In some situations, your doctor may decide to continue treatment instead of stopping it. Speak to your doctor for further advice.

    You may resume your immunosuppressive medication (including biologics) two weeks from onset of symptoms, provided that you have recovered from the COVID-19 related symptoms.

    Some people with COVID-19 will continue to experience mild symptoms (such as post-viral cough, lack of ability to small/taste) for longer than two weeks. Your doctor may recommend that you resume your immunosuppressive medications. To learn more about COVID-19 and IBD medications, please click here.

    If you have very active inflammation due to IBD but are at low risk of complications due to COVID-19, your doctor may recommend restarting your immunosuppressive medications sooner. This depends on your clinical status, and your doctor will balance your risk of complications from IBD with your risk of complications from COVID-19.

    If your symptoms last longer than 7-14 days, you should speak to your doctor.

    Speak to your doctor about registering you into the SECURE-IBD registry.

  • The number of people with IBD who have been infected with COVID-19 is constantly changing. There is an international database that reports on the outcomes of COVID-19 occurring in IBD patients, called Surveillance Epidemiology of Coronavirus Under Research Exclusion (SECURE-IBD).

    To access the database, please click here. Healthcare providers must submit each case manually and consequently many individuals with IBD who experience a mild infection are not represented in this data.

  • It is recommend that you continue to take your IBD medications. Do not discontinue any of your medications without speaking to your gastroenterologist first. Patients who discontinue their medications place themselves at risk of an IBD flare, which may elevate their risk of COVID infection and its complications. 

    If you experience symptoms or test positive for COVID-19, speak to your gastroenterologists to discuss whether you should temporarily hold your medications.
  • If you are on immunosuppressive medications, you may be at increased risk for infection and complications of COVID-19. We are basing this on what we know about IBD medications and infections in general. As COVID-19 is a new infection, we do not have enough information to understand whether or not IBD medications increase the risks of contracting COVID-19.

    However, that risk may be offset by the benefit of keeping your IBD under control.
    Immunosuppressive and biologic medications include:

    • Steroids: prednisone (Deltasone), methylprednisolone, hydrocortisone (Hydrocort, Cortate)
    • Immunomodulators: azathioprine (Imuran), 6-mercaptopurine (Purinethol), methotrexate
    • Anti-TNF biologics: infliximab (Remicade®, Inflectra®, RenflexisTM), adalimumab (Humira®), golimumab (Simponi®)
    • Anti-IL12/23 biologics: ustekinumab (Stelara®)
    • Anti-leukocyte migration biologics: vedolizumab (Entyvio®)
    • JAK inhibitor small molecules: tofacitinib (Xeljanz®)

    The following IBD treatments do not suppress your immune system:

    • 5-aminosalicylates: mesalamine, mesalazine (Asacol®, Mezavant®, Pentasa®), sulfasalazine (Salazopyrin®)
    • Locally acting steroids: budesonide (Entocort®), budesonide MMX (Cortiment®), steroid enemas
    • Enteral nutrition (formula feeds) or dietary therapies
    • Probiotics

    For more information about risk factors and COVD-19, visit our Are You at Risk page. 

  • In order to reduce spread of COVID-19, if your IBD is in remission and you are feeling well, delay any in-person visits to your doctor. Consult with your primary care physician and/or gastroenterologists to determine if they can assess you through video-telemedicine or by telephone, instead of an in-person visit.

    If your IBD is active, please speak to your doctor about your symptoms and attend any upcoming appointments. Your doctor may still wish to see you in-person, or through video-telemedicine or a phone call.

    Diagnostic testing (including laboratory tests, endoscopies, colonoscopies, CT scans, MRIs, and ultrasounds) may need to be delayed because of pressures faced by the health care system at this time. Please discuss the need to reschedule these with your doctor.

    For expert recommendations about clinic visits and IBD testing, visit our Clinic Visits page
  • It is normal to feel stressed because the COVID-19 pandemics an uncertain and stressful time. Fear and anxiety about this virus can be overwhelming and cause strong emotions in adults and children. Remember that people react differently to stressful situations and that people who already experience a lot of anxiety may find their anxiety worsening.

    It is important to be kind to yourself. Take time for yourself to manage your mental health. You are doing the best you can in a time when simply turning on the news can feel overwhelming. Take care of your body through a healthy diet, regular exercise, and plenty of sleep.

    Connect with others and maintain a strong support system. Help others if you can by checking in and being mindful of the supplies you keep at home. Take breaks and try to do activities you usually enjoy. Practice mindfulness and if needed, seek professional help with stress or anxiety.

    For more tips on coping with stress and anxiety during COVID-19, visit our Your Wellbeing page

  • There is currently no approved treatment to prevent or cure COVID-19.

    However, there are therapies that can help the symptoms of COVID-19 such as breathing support. Therapies can help people get through the disease course.

    Although there is currently no approved treatment for COVID-19, there are potential treatments being tested in research studies around the world. These include vaccines, antiviral medications, anti-malaria medications, and biologic medications targeting the immune system. None of these therapies have been shown to be effective to treat or prevent COVID-19 – yet!
  • Pregnancy alone does not make a person more at risk for COVID-19.

    So far, research suggests COVID-19 is not transmitted from mother to baby during pregnancy, during childbirth, or through breast milk. If a mother has symptoms of COVID-19, however, there is the chance that she can transmit the virus to her baby through droplets (from coughing, sneezing, etc.).

    For expert guidance on being pregnant and caring for newborns during the COVID-19 outbreak, please visit our Pregnancy and Newborns page
  • Stay home! The best thing pregnant women can do is stay as healthy as possible. Staying healthy will minimize the need to visit clinics or hospitals. This will minimize the potential of being exposed to people who are sick.

    Pregnant women with IBD should follow the same guidelines as everyone else, namely staying home, physical distancing, and practicing good hand hygiene. Importantly, people with IBD (pregnant or not) should continue taking their medications. Regardless of COVID-19, the risks of active inflammation from active IBD outweigh any potential risks of using medications.

    Mental health is also important for a healthy pregnancy, so see the mental health suggestions above or visit the Your Wellbeing page
  • A lot of the same guidelines for staying safe and healthy apply to those with newborns. Here are some tips:

    • Disinfect surfaces in your home that are frequently touched
    • Practice good hand hygiene
    • Use coughing etiquette (cover your cough by coughing into your elbow)
    • If you have even symptoms of illness, contact your doctor or public health
    • Stay home!  And keep your baby at home as much as possible
    • Minimizing exposing your baby to people living outside your home, except for health care providers.
    • Continue breastfeeding

    We know that having a baby is an exciting and perhaps scary time that is often share with family and friends. It may be difficult, but it is safest to keep your newborn as isolated as possible during this time.

    If you are a breastfeeding mother and are suspected or proven to have COVID-19, there are ways in which you can continue to breastfeed. Please see the guidance from the Canadian Pediatric Society 

  • Having a baby is exciting and anxiety-provoking at the best of times! It is normal if you are feeling both excited and scared about having a newborn during this uncertain time. 

    It is important to maintain psychological closeness with others, even if you can’t be together in person. Connect with loved ones in ways that you can (using technology or the telephone). Send photos of your baby to your family. Have video calls. Connect with other parents with newborns online.

    Stay in the now. Be mindful and thankful for what’s around you in the present. Try not to worry about all the “what ifs”. If you do have worries and fears, talk back to those worries and remind yourself of what you have now.

    Stay informed from reliable sources. Do your best to maintain overall health by staying mentally healthy, sleeping well, and eating well.

    For more guidance on being pregnant and caring for newborns during the COVID-19 outbreak, please visit our Pregnancy and Newborns page
  • If a member of your household is immunosuppressed, you should practice physical distancing (2 metres/6 feet apart) from other people to minimize the risk of becoming infected with the COIVD virus and then transmitting it to the member of your household who is immunosuppressed. Household members should:

    • Try to avoid in-person meetings.
    • Try to work from home. If not possible, speak to your doctor and speak to your employer about physical distancing at work.
    • Use services for vulnerable people (e.g. special grocery store times, pharmacy delivery, etc.)

    Clean your residence as best as possible to avoid transmission of the virus. Instructions for disinfecting your residence are available from the Centers for Disease Control and Prevention. While doing these activities, always maintain a distance of at least 2 arm-lengths (approximately 2 metres or 6 feet) from others.

    Refer to the Government of Canada guidance for more information on how to self-isolate at home when you may have been exposed and have no symptoms.

  • Do not travel outside of Canada. In addition, please see the travel advice provided by the Public Health Agency of Canada. Visit the Government of Canada's website for more information.

  • Physical distancing means:

    • Keep a distance of 2 metres (6 feet) from the nearest person
    • If possible, cancel group events and hold meetings virtually rather than in-person
    • Avoid people who are sick
    • Do not shake hands, hug, or engage in physical contact with other people, especially if they are sick
    • Practice good hand hygiene. Wash your hands with soap and water regularly after social contact, before meals, and often in between, or use hand sanitizer that contains at least 60% alcohol when soap and water is not available. Avoid touching your face. Cough into your sleeve.

    Self-isolation means:

    • Stay at home and monitor yourself for symptoms, even if mild, for 14 days
    • Avoid contact with others

    If you have no symptoms of COVID-19, you can still go outside for:

    • fresh air
    • a run
    • a bike ride
    • to walk the dog
    See the Government of Canada website for further instruction on when and how to self-isolate.
     
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are often used for pain, inflammatory conditions, and to reduce fever, including ibuprofen (Advil®, Motrin®) and naproxen (Aleve®). The association of these drugs with COVID-19 and complications is controversial, and Health Canada has stated that there is no association between NSAIDs and COVID complications.

    However, NSAIDs have also been associated with flare-ups of IBD, and therefore all IBD patients (whether taking immunosuppressive medications or not) should avoid starting these medications if possible.
  • Having a pelvic pouch, ileostomy, or colectomy alone does not put you at greater risk for COVID-19. If you have IBD but are not taking immunosuppressive medications, are not malnourished, and do not have severe active inflammation, you are at the same risk of infection and complications from COVID-19 as the general population.

    Having a pouch or ileostomy puts you at increased risk for dehydration if you have high output, severe diarrhea. If you have more diarrhea, increase your hydration with rehydrating liquids with electrolytes and contact your doctor.

    For more information about COVID-19 risk for IBD patients, please click here

  • Currently, there is no clear evidence to suggest that being on biologics causes you to have a more severe disease course. However, if you develop symptoms of COVID-19, speak to your gastroenterologist about whether you should temporarily change your medication schedule.

  • Our recommendations for physical distancing depend on your level of risk. Refer to our physical distancing risk chart to learn more.

  • It depends on your risk and exposure at work. If you are at medium or high risk for COVID-19 and have a lot of exposure (e.g. hospital emergency room), speak to your employer about switching to a role with less exposure if possible.

    Each case is unique and requires discussion with your healthcare provider and potentially with your employer. You will need to balance the public good from continuing your work as a healthcare worker with the importance of staying healthy and protecting yourself from COVID-19. Each case is unique and requires discussion with between the healthcare provider and the patient and potentially with the employer.

    For more guidance on essential work and COVID-19 if you have IBD, please click here. 
  • Infusion clinics are working hard to make sure they are safe environments for patients and workers. If you are experiencing symptoms or have tested positive for COVID-19, speak to your healthcare provider and infusion site to discuss options to reschedule your infusion. If you are unsure whether you are safe to attend your appointment at the infusion clinic, ask your clinic prior to your appointment.

    For more information on visit infusion clinics and access to your medications during the COVID-19 pandemic, please click here

  • Infusion clinics are screening patients and workers for COVID-19. Some of these screening strategies involve calling patients before coming into the clinic, sending online questionnaires when patients are reminded of their appointments, and more.

    Their screening tools are continuing to evolve as public health guidelines change. If the clinic asks to delay your appointment because you are symptomatic, please be patient – they are doing their best to protect others.

    Infusions clinics are also cleaning even more vigorously than usual. This involves disinfecting surfaces often, and ensuring patients wash their hands well as soon as they enter the clinic. Additionally, clinics are taking steps to maintain physical distancing. These steps include putting up screens, spacing out appointments to avoid crowding, and keeping ample space between patients.

    All of this means that clinics are scheduling fewer patients at a time in order to protect you. This might mean you will be rescheduled even if you’re not sick. Please be patient if the clinic needs to reschedule your appointment to another time.

    For more information on infusion clinics and access to medication during the COVID-19 pandemic, please click here
     
  • Some clinics and patient support programs are offering virtual assistance to train patients or caregivers in self-administering their medications. This option only exists for patients receiving a subcutaneous injection of their biologic medication. To find out if this is an option for you, please speak to your health care provider or patient support program coordinator. 

 

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  • Canada has among the highest incidence rates of Crohn's and colitis in the world.
  • 1 in 140 Canadians lives with Crohn’s or colitis.
  • Families new to Canada are developing these diseases for the first time.
  • Incidence of Crohn’s in Canadian kids under 10 has doubled since 1995.
  • People are most commonly diagnosed before age 30.

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