Table 4

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

	Continuing medical therapy in patients who have responded to intravenous steroid therapy*
Negative SARS-CoV-2 swab without signs of COVID-19 infection	Standard corticosteroid taper	Poorly bioavailable steroids†	Anti-TNF‡	Thromboprophylaxis§
	Accelerated corticosteroid taper 4–6 weeks	Thiopurine‡	Vedolizumab‡
Positive SARS-CoV-2 swab without signs of COVID-19 infection	Standard corticosteroid taper	Poorly bioavailable steroids†	Anti-TNF‡	Thromboprophylaxis§
	Accelerated corticosteroid taper 4–6 weeks	Thiopurine‡	Vedolizumab‡
Positive SARS-CoV-2 swab with signs of COVID-19 infection	Standard corticosteroid taper	Poorly bioavailable steroids†	Anti-TNF‡	Thromboprophylaxis§¶
Positive SARS-CoV-2 swab with signs of COVID-19 infection	Accelerated corticosteroid taper 4–6 weeks	Thiopurine‡	Vedolizumab‡

Medium grey is considered appropriate, light grey uncertain and dark grey inappropriate
*Patient has responded to intravenous corticosteroid therapy sufficiently to convert to oral prednisolone; standard or accelerated taper, switch methylprednisolone to prednisolone with taper as described.
†Switch from methylprednisolone to budesonide MMX/beclometasone.
‡Corticosteroid taper and start additional therapy at or soon after discharge.
§Continue for a period after discharge.
¶Disagreement index >1.
MMX, multimatrix; TNF, tumour necrosis factor.