First-line medical therapy | |||||
Negative SARS-CoV-2 swab WITHOUT respiratory symptoms | Inpatient intravenous steroids* | Poorly bioavailable steroids† | IFX alone | Tofacitinib | Discussion with COVID-19 specialist‡ |
Ambulatory intravenous steroids§ | Intravenous steroids*+IFX | Ciclosporin | Colectomy | ||
Positive SARS-CoV-2 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 SARS-CoV-2 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.