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Infliximab for severe ulcerative colitis and subsequent SARS-CoV-2 pneumonia: a stone for two birds
  1. Cristina Bezzio1,
  2. Gianpiero Manes1,
  3. Francesco Bini2,
  4. Lucienne Pellegrini1,
  5. Simone Saibeni1
  1. 1 Gastroenterology Unit, ASST Rhodense, Garbagnate Milanese, Italy
  2. 2 Pneumology Unit, ASST Rhodense, Garbagnate Milanese, Italy
  1. Correspondence to Dr Cristina Bezzio, Gastroenterology Unit, ASST Rhodense, Garbagnate Milanese, Italy; cribezzio03{at}yahoo.it

https://doi.org/10.1136/gutjnl-2020-321760

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    We read with interest the article by Neurath1 about the potential relationships between immunomodulating drugs for IBD and COVID-19. The infection can cause pneumonia, which in some cases leads to acute respiratory distress syndrome with multiorgan failure. These life-threatening cases are attributable to a strong upregulation of cytokine production, known as ‘cytokine storm syndrome’.2 This is why anticytokine therapies have been proposed for this condition.3 However, so far, empirical evidence supporting the use of such therapies is lacking.

    Here, we report the case of a 36-year-old man who was admitted to our hospital for a severe recurrence of ulcerative colitis.

    At admission, he had been taking mesalazine in both oral and topical formulations and he reported up to 12 bowel movements with blood. Laboratory tests showed mild normocytic anaemia (haemoglobin, 123 g/L), neutrophilic leucocytosis (neutrophils, 9420/μL), increased C reactive protein (CRP) (17.1 mg/dL; normal values <0.5 mg/dL) and hypoalbuminaemia (3.2 g/dL). Colonoscopy showed widely ulcerated mucosa, and …

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    Footnotes

    • Correction notice This article has been corrected since it published Online First. Figure 1 has been corrected.

    • Contributors CB,FB,GM,SS followed the patient and discussed clinical management.CB and SS wrote the manuscript.FP collected and analysed data.All authors approved content and list of authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.