VIDEO: Case report sheds light on ‘variances COVID-19 brings’ to UC treatment
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VANCOUVER, British Columbia — In this Healio video exclusive, Neslyne B. Augustin, MD, reviews the case of a patient with ulcerative colitis and concomitant SARS-CoV-2 infection, which she presented at the ACG Annual Scientific Meeting.
"This is a very important case because it involved a lot of different disciplines: infectious disease, gastroenterology and, of course, hospitalists,” Augustin, an internist at Tift Regional Medical Center in Georgia, told Healio.
According to Augustin, a 53-year-old white woman with morbid obesity and a history of UC presented with what appeared to be an acute flare, including abdominal pain, bloody diarrhea, nausea, vomiting and more than 25 bowel movements a day for 3 days. The patient tested positive for SARS-CoV-2.
“That did bring a lot of different questions, because as we are aware, many of the agents we use for ulcerative colitis tend to have an effect on the immune system,” Augustin said. “As we know, COVID-19 also has different effects on our bodies, and a lot of questions still need to be answered.”
The patient was treated with supportive care, including IV fluids and electrolyte replacement, as well as IV methylprednisolone, ciprofloxacin and metronidazole. Rectal mesalamine was added to her treatment regimen, leading to some improvement, although she later relapsed.
The patient began alternating treatment with infliximab and cyclosporine, Augustin noted, and although she initially showed some response to the infliximab, she relapsed again and underwent colectomy.
“I believe this case highlights that we need to be aware of the different variances that COVID-19 brings to treating patients with ulcerative colitis,” Augustin said.
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Augustin NB. Severe acute ulcerative colitis with concomitant SARS-CoV-2 infection: A case report
Presented at: ACG Annual Scientific Meeting; Oct. 20-25, 2023; Vancouver, British Columbia (hybrid meeting).
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