Guidance for patients with IBD during the COVID-19 pandemic

The American Gastroenterological Association (AGA) has published new COVID-19 guidance for gastroenterologists treating patients with inflammatory bowel disease (IBD).

Patients with IBD have particular concerns for their risk for infection and management of their medical therapies during the COVID-19 pandemic. This clinical practice update (AGA Clinical Practice Update on Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: Expert Commentary) incorporates the emerging understanding of COVID-19 and summarises available guidance for patients with IBD and the providers who take care of them.

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Recommendations for gastroenterologists and their patients who have IBD are:

1. During this pandemic, patients with IBD should continue IBD therapies including scheduled infusions.
2. Having IBD does not appear to increase the risk of SARS-CoV-2 infection or the development of COVID-19.
3. Instructions for patients with IBD who develop COVID-19 (fever, respiratory symptoms, digestive symptoms, etc):
   a. Stop thiopurines, methotrexate, tofacitinib.
   b. Stop biological therapies (including anti-TNF, ustekinumab, vedolizumab).
   c. Can restart therapies after complete resolution of COVID-19 symptoms. Patients should always speak with their health care team before stopping any medication. Patients should always speak with their health care team before stopping any medication.
4. Doctors should submit cases of IBD and confirmed COVID-19 to the SECURE-IBD registry at COVIDIBD.org.