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British Society of Gastroenterology guidance for management of inflammatory bowel disease during the COVID-19 pandemic
  1. Nicholas A Kennedy1,2,
  2. Gareth-Rhys Jones3,4,
  3. Christopher A Lamb5,6,
  4. Richard Appleby7,
  5. Ian Arnott4,
  6. R Mark Beattie8,
  7. Stuart Bloom9,
  8. Alenka J Brooks10,
  9. Rachel Cooney11,12,
  10. Robin J Dart13,14,
  11. Cathryn Edwards15,
  12. Aileen Fraser16,
  13. Daniel R Gaya17,18,
  14. Subrata Ghosh11,12,
  15. Kay Greveson14,
  16. Richard Hansen18,19,
  17. Ailsa Hart20,21,
  18. A Barney Hawthorne22,
  19. Bu'Hussain Hayee13,23,
  20. Jimmy K Limdi24,25,
  21. Charles D Murray14,
  22. Gareth C Parkes26,27,
  23. Miles Parkes28,
  24. Kamal Patel29,
  25. Richard C Pollok29,30,
  26. Nick Powell21,31,
  27. Chris S Probert32,33,
  28. Tim Raine28,
  29. Shaji Sebastian34,
  30. Christian Selinger35,
  31. Philip J Smith32,
  32. Catherine Stansfield36,
  33. Lisa Younge37,
  34. James O Lindsay26,27,
  35. Peter M Irving13,38,
  36. Charlie W Lees3,4
  1. 1 Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
  2. 2 University of Exeter, Exeter, UK
  3. 3 University of Edinburgh, Edinburgh, UK
  4. 4 Western General Hospital, Edinburgh, UK
  5. 5 Newcastle University, Newcastle upon Tyne, UK
  6. 6 Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  7. 7 Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  8. 8 Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  9. 9 University College London Hospitals NHS Foundation Trust, London, UK
  10. 10 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  11. 11 Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, UK
  12. 12 University of Birmingham, Birmingham, UK
  13. 13 King's College London, London, UK
  14. 14 The Royal Free Hospital, London, UK
  15. 15 Torbay and South Devon NHS Foundation Trust, Torquay, UK
  16. 16 University Hospitals Bristol NHS Foundation Trust, Bristol, UK
  17. 17 Glasgow Royal Infirmary, Glasgow, UK
  18. 18 University of Glasgow, Glasgow, UK
  19. 19 Royal Hospital for Children, Glasgow, UK
  20. 20 St Mark's Hospital, London, UK
  21. 21 Imperial College London, London, UK
  22. 22 University Hospital of Wales, Cardiff, UK
  23. 23 King’s College Hospital NHS Foundation Trust, London, UK
  24. 24 The Pennine Acute Hospitals NHS Trust, Manchester, UK
  25. 25 University of Manchester, Manchester, UK
  26. 26 Barts and the London School of Medicine and Dentistry, London, UK
  27. 27 The Royal London Hospital, Barts Health NHS Trust, London, UK
  28. 28 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
  29. 29 St George’s University Hospitals NHS Foundation Trust, London, UK
  30. 30 St George’s, University of London, London, UK
  31. 31 Imperial College Healthcare NHS Trust, London, UK
  32. 32 Liverpool University Hospitals NHS Foundation Trusts, Liverpool, UK
  33. 33 University of Liverpool, Liverpool, UK
  34. 34 Hull University Teaching Hospitals NHS Trust, Hull, UK
  35. 35 Leeds Teaching Hospitals NHS Trust, Leeds, UK
  36. 36 Salford Royal NHS Foundation Trust, Salford, UK
  37. 37 Crohn's and Colitis UK, St Albans, Hertfordshire, UK
  38. 38 Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Professor Charlie W Lees, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, UK; charlie.lees{at}ed.ac.uk

Abstract

The COVID-19 pandemic is putting unprecedented pressures on healthcare systems globally. Early insights have been made possible by rapid sharing of data from China and Italy. In the UK, we have rapidly mobilised inflammatory bowel disease (IBD) centres in order that preparations can be made to protect our patients and the clinical services they rely on. This is a novel coronavirus; much is unknown as to how it will affect people with IBD. We also lack information about the impact of different immunosuppressive medications. To address this uncertainty, the British Society of Gastroenterology (BSG) COVID-19 IBD Working Group has used the best available data and expert opinion to generate a risk grid that groups patients into highest, moderate and lowest risk categories. This grid allows patients to be instructed to follow the UK government’s advice for shielding, stringent and standard advice regarding social distancing, respectively. Further considerations are given to service provision, medical and surgical therapy, endoscopy, imaging and clinical trials.

  • crohn's disease
  • ulcerative colitis
  • crohn's colitis
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Footnotes

  • NAK, G-RJ and CAL are joint first authors.

  • Twitter @DrNickKennedy, @gastro_GRJ, @DrChrisLamb, @rnappleby, @RMBeattie50, @alenkabrooks, @rjcdart, @CathrynmEdwards, @carmunnock, @paedsrh, @ABHawthorne, @IBDdoc, @jklimdi, @NickPowellLab, @ChrisProbert62, @IBD_MB, @ibdseb, @DrPhilipJSmith, @ibdportal, @LisaYounge2, @charlie_lees

  • Contributors CWL, NAK, G-RJ and CAL led the writing group. All authors contributed to either or both discussion regarding guidance set out in this manuscript and editing of the final document.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests For details of conflicts of interest see online supplementary table 1.

  • Patient and public involvement Real time, valuable feedback from patients engaging with the IBD Registry and Crohn’s and Colitis UK tools, as well as previous versions of this guidance on the British Society of Gastroenterology website, has helped clarify ambiguities in the original risk stratification grid. This has provided a powerful and unique mechanism for rapid patient-clinician co-development of this clinical guidance.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article.

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