Infliximab for severe ulcerative colitis and subsequent SARS-CoV-2 pneumonia: a stone for two birds
Cristina Bezzio, Gianpiero Manes, Francesco Bini, Lucienne Pellegrini, Simone Saibeni
Abstract
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 …