Moreover, a recent study of data from the SECURE-IBD registry reported that thiopurine monotherapy and thiopurines in combination with TNF inhibitor therapy were associated with worse COVID-19 outcomes compared with TNF inhibitor monotherapy.24 In contrast, researchers have postulated that methotrexate therapy may decrease the cytokine storm associated with COVID-19.25,26 However, our results suggest worse outcomes associated with methotrexate monotherapy compared with TNF inhibitor monotherapy. This evidence concerns the gene TNF and inflammatory bowel disease.