Table 2

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

	First-line medical therapy
Negative COVID-19 swab WITHOUT respiratory symptoms	Inpatient intravenous steroids*	Poorly bioavailable steroids†	IFX alone	Tofacitinib	Discussion with COVID-19 specialist‡
Negative COVID-19 swab WITHOUT respiratory symptoms	Ambulatory intravenous steroids§	Intravenous steroids*+IFX	Ciclosporin	Colectomy
Positive COVID-19 swab WITHOUT respiratory symptoms or signs of COVID-19 pneumonia	Inpatient intravenous steroids*	Poorly bioavailable steroids†	IFX alone	Tofacitinib	Discussion with COVID-19 specialist‡
	Ambulatory intravenous steroids§	Intravenous steroids*+IFX	Ciclosporin	Colectomy
Positive COVID-19 swab WITH symptoms or signs of COVID-19 pneumonia	Inpatient intravenous steroids*	Poorly bioavailable steroids†	IFX alone	Tofacitinib	Discussion with COVID-19 specialist‡
	Ambulatory intravenous steroids§	intravenous steroids*+IFX	Ciclosporin	Colectomy

Green is considered appropriate, yellow uncertain and red inappropriate.
*Steroids, intravenous hydrocortisone 100 mg four times a day or intravenous methylprednisolone 60 mg daily as an inpatient.
†Budesonide MMX 9 mg/beclometasone 5 mg once daily orally as an inpatient; IFX (either 5 mg/kg or 10 mg/kg).
‡Discussion with appropriate COVID-19 specialist as per local availability.
§Intravenous methylprednisolone 60 mg daily as an outpatient.
IFX, infliximab; MMX, multimatrix.