Table 4 Guidelines for patients with inflammatory bowel disease during COVID-19 pandemic (adapted from Mao et al. [88])
| Management Priority | Recommendation |
|---|---|
| Risk factors for SARS-CoV-2 infection |
Patients taking immunosuppressive agents Malnourished patients with active IBD Elderly IBD patients IBD patients with comorbid medical conditions Pregnant IBD patients |
| Drug therapy of IBD |
Continue current therapy if disease is stable Continue use of mesalamine, corticosteroids, anti-TNF-alpha biologic agents (e.g. infliximab) Consider use of enteral nutrition if biologics not accessible Avoid commencement of tofacitinib unless no alternatives are available |
| Endoscopy and surgical procedures |
Defer endoscopy and elective surgery Screen for COVID-19 by nucleic acid detection and chest CT before emergency surgery |
| Symptomatic IBD patients |
Contact specialist team about option to attend outpatient clinic with use of PPE if temperature remains > 38 °C If suspected diagnosis of COVID-19, suspend use of immunosuppressants and biologic agents after consulting own gastroenterologist |