Continuing medical therapy* | |||||
Negative COVID-19 swab WITHOUT respiratory symptoms | Standard steroid taper | Accelerated steroid taper <4 weeks | Thiopurine† | Ustekinumab† | Tofacitinib† |
Accelerated steroid taper 4–6 weeks | Poorly bioavailable steroids‡ | Anti-TNF† | Vedolizumab† | Thromboprophylaxis§ | |
Positive COVID-19 swab WITHOUT respiratory symptoms or signs of COVID-19 pneumonia | Standard steroid taper | Accelerated steroid taper <4 weeks | Thiopurine† | Ustekinumab† | Tofacitinib† |
Accelerated steroid taper 4–6 weeks | Poorly bioavailable steroids‡ | Anti-TNF† | Vedolizumab† | Thromboprophylaxis§ | |
Positive COVID-19 swab WITH symptoms or signs of COVID-19 pneumonia | Standard steroid taper | Accelerated steroid taper <4 weeks | Thiopurine† | Ustekinumab† | Tofacitinib† |
Accelerated steroid taper 4–6 weeks | Poorly bioavailable steroids‡ | Anti-TNF† | Vedolizumab† | Thromboprophylaxis§ |
Green is considered appropriate, yellow uncertain and red inappropriate.
*Patient has responded to intravenous steroid therapy.
†Steroid taper and start additional therapy at or soon after discharge.
‡Switch from corticosteroids to budesonide MMX 9 mg daily/beclometasone 5 mg daily.
§Continue for a period after discharge.
MMX, multimatrix; TNF, tumour necrosis factor.