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Table 4 Guidelines for patients with inflammatory bowel disease during COVID-19 pandemic (adapted from Mao et al. [88])

From: COVID-19 in adult patients with pre-existing chronic cardiac, respiratory and metabolic disease: a critical literature review with clinical recommendations

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
  1. PPE Personal protective equipment