Table 3

Appropriateness of treatment options in acute severe UC in the context of the COVID-19 pandemic: rescue therapy

	Rescue therapy				Failure of rescue therapy
Negative COVID-19 swab WITHOUT respiratory symptoms	Continue intravenous steroids alone	IFX +steroids	Intravenous ciclosporin +steroids	Colectomy	Delay surgery
Negative COVID-19 swab WITHOUT respiratory symptoms		IFX, stop steroids	Intravenous ciclosporin, stop steroids	Discussion with COVID-19 specialist*	Delay surgery
Positive COVID-19 swab WITHOUT respiratory symptoms or signs of COVID-19 pneumonia	Continue intravenous steroids alone	IFX +steroids	Intravenous ciclosporin +steroids	Colectomy	Delay surgery
		IFX, stop steroids	Intravenous ciclosporin, stop steroids	Discussion with COVID-19 specialist*	Delay surgery
Positive COVID-19 swab WITH symptoms or signs of COVID-19 pneumonia	Continue intravenous steroids alone	IFX +steroids	Intravenous ciclosporin +steroids	Colectomy	Delay surgery
		IFX, stop steroids	Intravenous ciclosporin, stop steroids	Discussion with COVID-19 specialist*	Delay surgery

Green is considered appropriate, yellow uncertain and red inappropriate. Steroids, intravenous hydrocortisone 100 mg four times daily or intravenous methylprednisolone 60 mg daily as an inpatient; IFX (either 5 mg/kg or 10 mg/kg).
*Discussion with appropriate COVID-19 specialist as per local availability.
IFX, infliximab.