De Novo Crohn’s Disease Diagnosed in the Setting of Acute SARSCov- 2 Infection Requiring Escalation of Infliximab Therapy Guided by Personalized Pharmacokinetics

Author(s): Martin Varea Romo, Kishor Acharya, Nathan R Shelman, Phillip Minar, Lee A Denson, Samir Softic*

Here, we describe a 7-year-old girl who was diagnosed with an earlyonset Crohn’s disease in the setting of COVID-19 illness. Her disease process responded poorly to standard infliximab dosing, necessitating repeat hospitalizations and red blood cell transfusions. Remission was subsequently induced using a personalized infliximab pharmacokinetic profile based on therapeutic drug monitoring. While the initial data does not support a link, several case reports suggest an association between COVID-19 illness and de-novo development of IBD, especially in young female patients. We report, to our knowledge, the youngest patient who developed early-onset Crohn’s disease in the setting of concomitant SARS-CoV-2 infection.