The 2023 Impact of Inflammatory Bowel Disease in Canada: COVID-19 and IBD

Abstract The COVID-19 pandemic had a monumental impact on the inflammatory bowel disease (IBD) community. At the beginning of the pandemic, knowledge on the effect of SARS-CoV-2 on IBD was lacking, especially in those with medication-suppressed immune systems. Throughout the pandemic, scientific literature exponentially expanded, resulting in clinical guidance and vaccine recommendations for individuals with IBD. Crohn’s and Colitis Canada established the COVID-19 and IBD Taskforce to process and communicate rapidly transforming knowledge into guidance for individuals with IBD and their caregivers, healthcare providers, and policy makers. Recommendations at the onset of the pandemic were based on conjecture from experience of prior viruses, with a precautionary principle in mind. We now know that the risk of acquiring COVID-19 in those with IBD is the same as the general population. As with healthy populations, advanced age and comorbidities increase the risk for severe COVID-19. Individuals with IBD who are actively flaring and/or who require high doses of prednisone are susceptible to severe COVID-19 outcomes. Consequently, sustaining maintenance therapies (e.g., biologics) is recommended. A three-dose mRNA COVID-19 vaccine regimen in those with IBD produces a robust antibody response with a similar adverse event profile as the general population. Breakthrough infections following vaccine have been observed, particularly as the virus continues to evolve, which supports receiving a bivalent vaccine booster. Limited data exist on the impact of IBD and its therapies on long-term outcomes following COVID-19. Ongoing research is necessary to address new concerns manifesting in those with IBD throughout the evolving pandemic. In April 2021, Crohn’s and Colitis Canada’s COVID-19 and IBD Taskforce produced the 2021 Impact of COVID-19 & Inflammatory Bowel Disease in Canada. This report summarized the key learnings of the impact of COVID-19 on the IBD community at the one-year anniversary since the COVID-19 pandemic was declared by the World Health Organization. During the first year of the pandemic, and before the widespread dissemination of COVID-19 vaccines, the body of the scientific literature was synthesized and communicated to the IBD community through Crohn’s and Colitis Canada’s COVID-19 and IBD Taskforce using online resources and a webinar series. The scientific literature from that time period suggested that those with IBD shared a similar risk of beco