Guidance for Pediatric Caregivers and Patients

Updates on COVID-19 and IBD

Deciding when to send my child with IBD to school or public events

Caregivers of children with IBD are often faced with difficult decisions as the symptoms of their disease impact your child’s ability to attend school or participate in their favorite after-school activity. The Foundation recognizes that caregivers are worried about their children and their risk of contracting the coronavirus. According to the World Health Organization, the risk of coronavirus in children and young adults is lower than is currently reported in older adults. The WHO also notes that most children that have contracted coronavirus experienced a mild or moderate case with similar symptoms to the flu.1 


Teach healthy hygiene practices to your child or young adult

Caregivers are encouraged to teach children and young adults healthy hygiene habits including handwashing, not touching their face, and using their elbow to cover their mouth when sneezing or coughing. When using a tissue, it is important to throw it away after use. 

Resources:

Get information from credible sources

For caregivers and families who are living in communities (cities and towns) where there are a large-number of coronavirus cases, the best source of information is the CDC and your local health department websites. The news media is providing general information, but may not be providing specifics for your community. As you and your family make decisions, please visit your local health department website for specific guidance. Local health departments are providing guidance that pertains to local risk and precautions specific to those people living and going to school in that area. Some local health departments may also have alerts that you can sign up for to stay updated on any new information about your area. 

High-risk groups

The information that is known so far about the 2019 novel coronavirus is based on what has been reported from cases in Wuhan, China, and we are learning more as the virus has spread to other countries. Based on the reported cases, we know that there may be individuals that are at higher risk. 

Individuals in high-risk groups as defined by the CDC, are being advised to take extra precautions. Children are not considered a high-risk group at this time. High-risk groups include those with weakened immune systems, however, it’s important to know that not all IBD patients have weakened immune systems. To learn more about all high-risk groups, visit:

How do I know if my child has a weakened immune system?  

The term weakened immune system or immune suppression are general terms that describe the lack of an appropriate response by the body to fighting diseases and organisms that may be harmful, such as viruses and certain bacteria. Having a weakened immune system can occur for many reasons including medication, recent surgeries, age, genetics, or having a chronic illness. Patients with IBD experience many of these factors, and can have a weakened immune system.

Children with IBD on specific medications that suppress the immune system may need to take extra precautions. Caregivers are encouraged to speak with their GI/healthcare provider and discuss any extra precautions related to attending school, after school activities or public events like concerts and sporting events. 

For more information on IBD medications, click here.

IBD medication: travel and large event recommendations

Travel should be carefully considered based on a number of factors including their family preferences, your child’s disease-related risk, recommendations from their doctor, the status of their health, and travel advisories. Current travel health notices are located here: https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

Click here for additional guidance on specific medications and current recommended precautions.

Travel should be carefully considered based on a number of factors including their family preferences, your child’s disease-related risk, recommendations from their doctor, the status of their health, and travel advisories.

Research on the coronavirus and the GI tract

According to two papers published in the journal Gastroenterology, patients with COVID-19 may also experience gastrointestinal symptoms, including diarrhea, nausea, vomiting and abdominal discomfort prior to the common respiratory symptoms2,3. One of the publications is a study, based in China, which was done on a small sample of 73 patients who were in the hospital with confirmed coronavirus3. The gastrointestinal symptoms that have been observed globally are less common and there is variability based on the populations and cases that were observed.

Reminders for all patients

A list of publications referenced by the CDC can be found here: https://www.cdc.gov/coronavirus/2019-ncov/publications.html 

 

This information was developed by members of the Foundation's National Scientific Advisory Committee

Last updated: 3/11/2020

References

 1 World Health Organization: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf accessed March 6, 2020.

2 Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroentrology, 2020. Article in press. https://www.gastrojournal.org/article/S0016-5085(20)30281-X/pdf. Accessed March 6, 2020

3 Xiao F, Tang M, Zheng X, Liu Y, Li, X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology, 2020. Article in press.https://www.gastrojournal.org/article/S0016-5085(20)30282-1/pdf Accessed March 6, 2020.