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The ongoing pandemic of coronavirus disease 2019 (COVID-19) is emerging as a public health crisis worldwide Patients with COVID-19 range from being asymptomatic to suffering from severe pneumonia, acute respiratory distress syndrome (ARDS), and multiple organ failure (MOF) Gastrointestinal (GI) symptoms have been reported in a number of patients with COVID-19, suggesting that GI microbiota may play a role in the pathogeneses of the disease Theoretically, patients with confirmed inflammatory bowel disease (IBD) treated with immune-based therapies may be at a higher risk of manifesting a severe form of COVID-19, owing to immune system impairment This hypothesis has evoked the concerns of patients and treating physicians throughout the pandemic However, surprisingly, the findings of a number of studies show that immunosuppressive therapies, such as anti-TNF agents, could reduce the severity of symptoms associated with Covid-19 Dysbiosis of gut microbiota, characteristic of IBD patients, can be positively changed after using anti-TNF agents Vitamin D has been revealed to have a profound effect on reducing the viral infections, aside from its role in modulating the gut microbiome In this review, we discuss possible susceptibility of IBD patients to SARS-CoV-2 infection, the impact of immunosuppressive therapies on the course of SARS-CoV-2 infection in patients with IBD, and the potential protective role of gut microbiota against COVID-19 in patients with IBD in the presence of normal vitamin D levels © 2020, ALÖKI Kft , Budapest, Hungary

applied ecology and environmental research

COVID-19 INFECTION IN INFLAMMATORY BOWEL DISEASE PATIENTS TREATED WITH TNF-Α ANTAGONISTS: A POSSIBLE CRITICTAL ENROLLMENT OF GUT MICROBIOTA AND VITAMIN D LEVEL – A REVIEW