key: cord-0046020-qn7uf0yi
authors: D’Amico, Ferdinando; Baumgart, Daniel C.; Danese, Silvio; Peyrin-Biroulet, Laurent
title: Response
date: 2020-06-20
journal: Clin Gastroenterol Hepatol
DOI: 10.1016/j.cgh.2020.06.038
sha: 28dcdc847a8890993b8fc67122133a924eed6c29
doc_id: 46020
cord_uid: qn7uf0yi

nan

We appreciate the thoughtful comments of Perisetti and colleagues. In line with our paper they support our hypothesis that diarrhea in patients with COVID-19 may be related not only to the activity of the new coronavirus, but also to the drugs used for its treatment as antibiotics and antivirals. Interestingly, they add that even the cytokine storm generated by COVID-19 may play a role in diarrhea etiopathogenesis by influencing the gut-brain axis and causing an increased intestinal permeability 1 . If this theory is confirmed, the use of biological drugs such as tumor necrosis factor (TNF) inhibitors, which selectively block a pro-inflammatory cytokine and small molecules such as JAK-inhibitors, that target entire inflammatory pathways could represent a possible therapeutic option. Two case reports have previously described cases of COVID-19 patients with inflammatory bowel diseases successfully treated with anti-TNF drug 2 or JAK inhibitor 3 , but the impact of these therapies on diarrhea has not yet been investigated.

Pediatric Crohn's Disease and Multisystem Inflammatory Syndrome in Children (MIS-C) and COVID-19 Treated with Infliximab

Case Report of a SARS-CoV-2 Infection in a Patient With Ulcerative Colitis on Tofacitinib