• Infliximab and Abatacept significantly reduce the all-cause 28-day mortality in acute COVID-19 (hospitalised patients).
  • Up to date vaccination is critical for patients on Infliximab, and especially those on Infliximab plus an immunomodulator, like Azathioprine, because they result in reduced antibody production (lack of neutralising antibodies is a hypothesised cause of Long Covid).
  • Corticosteroids are associated with more severe acute COVID-19 outcomes.
  • Having IBD very likely increases your risk of getting Shingles, i.e. Varicella Zoster Virus (VZV) reactivation, post-SARS-CoV-2 by a factor of 3.


Crohn’s and Colitis UK provide summarised evidence for research on the intersection of IBD and Covid-19 (6 studies at time of writing), among other useful things. In summary:

    • People taking Infliximab were less likely to have antibodies to coronavirus than people taking Vedolizumab.
    • People taking an immunomodulator, like Azathioprine, as well as Infliximab were the least likely to have antibodies after being infected with coronavirus.
    • Breakthrough infection was significantly more frequent in patients treated with Infliximab. (read the paper)
    • Corticosteroids are associated with more severe acute COVID-19 outcomes, while biologic medications are not.

Results from clinical trials:

  • ACTIV-1 IM
    • All-cause 28-day mortality in patients hospitalised with acute COVID-19 pneumonia: (read the paper)
      • 11.0% for Abatacept vs 15.1% for placebo (OR: 0.41-0.94 (95% CI))
      • 10.1% for Infliximab vs 14.5% for placebo (OR: 0.39-0.90 (95% CI))

Results from retrospective studies: