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 SARS-CoV-2 swab WITHOUT respiratory symptomsStandard steroid taperAccelerated steroid taper <4 weeksThiopurine†Ustekinumab†Tofacitinib†
Accelerated steroid taper 4–6 weeksPoorly bioavailable steroids‡Anti-TNF†Vedolizumab†Thromboprophylaxis§
Positive SARS-CoV-2 swab WITHOUT respiratory symptoms or signs of COVID-19 pneumoniaStandard steroid taperAccelerated steroid taper <4 weeksThiopurine†Ustekinumab†Tofacitinib†
Accelerated steroid taper 4–6 weeksPoorly bioavailable steroids‡Anti-TNF†Vedolizumab†Thromboprophylaxis§
Positive SARS-CoV-2 swab WITH symptoms or signs of COVID-19 pneumoniaStandard steroid taperAccelerated steroid taper <4 weeksThiopurine†Ustekinumab†Tofacitinib†
Accelerated steroid taper 4–6 weeksPoorly 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.