IBD in the time of COVID-19 – Dr. Michael Beyak
Kassandra, Coyle, MSc'22 Candidate (Translational Medicine)
At the January 21st Medical Grand Rounds, the TMED students had the pleasure and privilege to learn from Dr. Michael Beyak. With a presentation entitled “IBD in the time of COVID-19”, Dr. Beyak presented on the common concerns of IBD patients, the impact and risks of IBD on COVID-19, as well as the concerns and guidelines for the COVID-19 vaccine.
Inflammatory bowel disease (IBD) is the umbrella term for several conditions characterized by the inflammation of the gastrointestinal (GI) tract, including Crohn’s Disease and Ulcerative Colitis. A well-justified concern for IBD patients is whether or not they are at a higher risk for developing COVID-19. In addition to being immunocompromised, IBD patients spend significantly more time in potentially high-risk healthcare settings. However, according to the literature, most studies have found that the rate of test positivity is nearly identical, if not decreased in the IBD population compared to the general community (1).
The SECURE-IBD database was created to monitor and report outcomes of COVID-19 in the global IBD population. Data generated from this registry has established that disease activity influences COVID-19 outcomes, with an increased risk of a severe outcome in response to active IBD (2). Additional predictors of poor outcomes include age, comorbidities, and the use of certain medications. Some immunosuppressive IBD medications may be associated with severe outcomes, with oral/parental steroids having the highest risk (2). However, stopping medication comes with the risk of disease flare, which impacts COVID-19 susceptibility and may require steroid treatment to get the disease back under control. In his presentation, Dr. Beyak alluded to the fact that most of the treatments prescribed to patients are relatively safe and that patients concerned about their medication should contact their physician with any questions.
Many IBD patients have concerns about the COVID-19 vaccine. At this time there isn’t any direct data to address these concerns as patients with autoimmune diseases and those that are immunosuppressed were excluded from vaccine trials. Though we can extrapolate upon data from other vaccinations and their impact on patients (3,4). Many other vaccines do not precipitate flares of IBD and are effective in the immunocompromised population. It is currently recommended that patients with IBD receive the COVID-19 vaccine and consult their physician regarding any concerns.
During the post grand round discussion, Dr. Beyak and the TMED students focused on how COVID-19 has affected IBD patients’ lifestyles. The many uncertainties surrounding the pandemic have had a negative impact on the mental health of many patients and has led to increased levels of stress and anxiety. Many ways in which people manage stress involve social interactions and activities that are done outside of the home, both of which have been severely limited. Dr. Beyak highlighted the importance of maintaining some normalcy during the pandemic, encouraging getting outside and exercising as a means of stress management. It is important to maintain relationships with various social supports and find new ways to connect with others. Furthermore, it is important to remember that healthcare is still easily accessible despite the limitations and any concerns should be brought to the attention of your physician.
The discussion then transitioned into how this information is presented in the media. Dr. Beyak described the challenges he has faced in keeping up with rapidly changing information. He highlighted the importance of critically evaluating everything you read; just because something has COVID-19 in the title does not make it good information. For patients looking to learn, he suggested starting with well-recognized patient advocacy organizations, such as Crohn’s and Colitis Canada (5).
Finally, the TMED students learned about Dr. Beyak’s educational history and his journey to becoming a clinician scientist. Dr. Beyak completed his undergrad at Queen’s University where he began his journey in research under the supervision of his now colleague, Dr. Stephen Vanner. Dr. Beyak went on to complete medical school and residency at the University of Toronto, where he continued to be involved in research training. Currently, Dr. Beyak is embarking on a clinically focused career, while still collaborating with his colleagues in the Gastrointestinal Diseases Research Unit (GIDRU). Throughout his career Dr. Beyak has enjoyed the opportunities to combine his love for teaching and research while also having the opportunity to look after patients.
It was a pleasure to hear Dr. Michael Beyak’s presentation on the impact of COVID-19 on IBD. On behalf of the TMED graduate program, I would like to sincerely thank him for his time and expert insight.
- Gubatan, J. et al. SARS-CoV-2 Testing, Prevalence, and Predictors of COVID-19 in Patients with Inflammatory Bowel Disease in Northern California. Gastroenterology 159, (2020).
- Current Summary Data. SECURE-IBD Database (2021). Available at: https://covidibd.org/current-data/. (Accessed: 24th January 2021)
- Park, S. H. et al. Efficacy of Hepatitis A Vaccination and Factors Impacting on Seroconversion in Patients with Inflammatory Bowel Disease. Inflammatory Bowel Diseases 20, 69–74 (2014).
- Gisbert J. et al. Efficacy of hepatitis B vaccination and revaccination and factors impacting on response in patients with inflammatory bowel disease. American Journal of Gastroenterology 107, (2012).
- About Crohn's & Colitis. COVID-19 and IBD - COVID-19 and IBD Available at: https://crohnsandcolitis.ca/About-Crohn-s-Colitis/COVID-19-and-IBD. (Accessed: 24th January 2021)