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

Table 5 Approach to diminish the spread of coronavirus disease 2019 for patients with inflammatory bowel disease[10]

	Approach to diminish the spread of COVID-19 for patients with IBD
Inpatient clinic	(1) Hospitalized patients with IBD relocated to an isolated area/building, if possible, minimizing exposure to the virus; and (2) Test for coronavirus 2019 with nasopharyngeal swabs (PCR) before hospitalization
Outpatient clinic	(1) Visits rescheduled if possible; (2) Medical staff monitor patients via telemedicine (e.g., remote video and telephone call); (3) Laboratory tests strictly limited; use fecal calprotectin (home modality, stool collection kit picked up by express mail services, if possible); (4) Endoscopy and image procedures only for urgent cases; (5) Patients should be advised to keep hygienic measures, avoid nonessential travels, and stay at home or work on a home-office basis; (6) Recommendations to maintain adequate hydration and nutrition status; and (7) Advise patients to continue their therapies, especially if in remission
Infusion center	(1) No accompanying person permitted; (2) Rearrangement of seats allowing a distance of at least 1.5 m in between; (3) Surgical masks for both patients and healthcare professionals; (4) Pre-admission protocol to assess for acute respiratory tract symptoms among patients with IBD and their contacts; (5) Selection of patients that could have their infusion postponed for 1-2 wk to let more space available for rearrangements of seats (those with clinical and endoscopic remission); and (6) Preference, if possible, for those biologics that can be offered subcutaneously, at home, instead of intravenously, to avoid overcrowding in the infusion center

IBD: Inflammatory bowel disease; COVID-19: Coronavirus disease 2019; PCR: Polymerase chain reaction.