Table 4

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

	Continuing medical therapy*
Negative COVID-19 swab WITHOUT respiratory symptoms	Standard steroid taper	Accelerated steroid taper <4 weeks	Thiopurine†	Ustekinumab†	Tofacitinib†
Negative COVID-19 swab WITHOUT respiratory symptoms	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.