How to manage inflammatory bowel disease during the COVID-19 pandemic: A guide for the practicing clinician

Table 2 Management of patients attending outpatient clinic with mildly active inflammatory bowel disease in the scenario of the asymptomatic severe acute respiratory syndrome coronavirus 2 infection or confirmed or suspected coronavirus disease 2019[12,20,26,27]

	Management
Asymptomatic infection with SARS-CoV-2	(1) Budesonide, aminosalycilates, antibiotics, and topical therapy may be used if needed; (2) Hold immunomodulators, tofacitinib, and biologics for 2 wk; (3) Taper or withdraw corticosteroids (prednisone < 20 mg/d); and (4) Monitoring for 2 wk for COVID-19 to present
Mild COVID-19	(1) Budesonide, aminosalycilates, antibiotics, and topical therapy may be used if needed; (2) Hold immunomodulators, tofacitinib, and biologics for 2 wk; (3) Taper or withdraw systemic corticosteroids); and (4) Monitoring for 2 wk for COVID-19 symptoms to disappear
COVID-19 with pulmonary involvement without SHS	(1) Budesonide, aminosalycilates, antibiotics, and topical therapy may be used if necessary; (2) Hold immunomodulators, tofacitinib, and biologics for at least 2 wk or until COVID-19 resolves; and (3) Taper or withdraw systemic corticosteroids

Immunomodulators refer to thiopurines and methotrexate. SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; COVID-19: Coronavirus disease 2019; SHS: Systemic hyperinflammation syndrome.