Table 3.

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

	Rescue therapy				Failure of rescue therapy
Negative SARS-CoV-2 swab WITHOUT respiratory symptoms	Continue intravenous steroids alone	IFX +steroids	Intravenous ciclosporin +steroids	Colectomy	Delay surgery
		IFX, stop steroids	Intravenous ciclosporin, stop steroids	Discussion with COVID-19 specialist*
Positive SARS-CoV-2 swab WITHOUT respiratory symptoms or signs of COVID-19 pneumonia	Continue intravenous steroids alone	IFX +steroids	Intravenous ciclosporin +steroids	Colectomy	Delay surgery
		IFX, stop steroids	Intravenous ciclosporin, stop steroids	Discussion with COVID-19 specialist*
Positive SARS-CoV-2 swab WITH symptoms or signs of COVID-19 pneumonia	Continue intravenous steroids alone	IFX +steroids	Intravenous ciclosporin +steroids	Colectomy	Delay surgery
		IFX, stop steroids	Intravenous ciclosporin, stop steroids	Discussion with COVID-19 specialist*

Green is considered appropriate, yellow uncertain and red inappropriate. Steroids, intravenous hydrocortisone 100 mg four times daily or intravenous methylprednisolone 60 mg daily as an inpatient; IFX (either 5 mg/kg or 10 mg/kg).

*Discussion with appropriate COVID-19 specialist as per local availability.

IFX, infliximab.