TABLE 1.

Initial Recommendations by Different Societies for IBD Patients During the COVID-19 Pandemic

IBD Patients	IBD Patients Not Infected With SARS-CoV-2			IBD Patients Infected With SARS-CoV-2
	Prevention	In Remission	In Flare	Without COVID-19 Symptoms	With COVID-19 Symptoms
China¹⁵		- Continue treatment with caution. - A new prescription or increase in dose of an immunosuppressant is not recommended. Enteral nutrition might be used if biologics are not available.	- Contact IBD doctor for suitable medicine.	- Screen for COVID-19 with serology and imaging before emergency surgery.	- Contact IBD doctor if temperature rises above 38°C. - Suspend immunosuppressants and biologics after consultation with IBD doctor.
Italy¹⁶		- Low dose and short-term steroids are safe. - Thiopurines and JAK inhibitors: do not stop in patients following prevention strictly. Delay the start of new therapies.	- Steroids can be used in case of need.		- Low-dose and short-term steroids are probably safe in patients with COVID-19 pneumonia.
AGA¹⁷		- Continue IBD therapies. - Continue infusion at appropriate centers.		- Lower doses of prednisone (< 20mgmg/d) or transition to budesonide. - Halt thiopurines, methotrexate and tofacitinib temporarily. - Dosing of biologics should be delayed for 2 weeks while monitoring for symptoms.	- Hold thiopurines, methotrexate, tofacitinib, and biologics during illness. - Restart after Complete resolution or, when follow-up viral testing is negative, or serology indicates convalescence. - Careful risk assessments for treatments of COVID-19. - Limit IV steroids to 3 days, at which point the decision to proceed with a calcineurin inhibitor or infliximab will be made in patients with active IBD. - Consider testing for CMV activation.
IOIBD¹⁴ (The International Organization for the Study of Inflammatory Bowel Diseases)	- Reduce the dose or stop prednisone.- In case of an immune modulator with a biologic, dose may be reduced.	- Continue to receive infusions in an infusion center.		- Discontinue immune modulators. - Restart medications if patients do not show symptoms after 2 weeks.	- Discontinue immune modulators. - Restart medications if symptoms have completely resolved or after 2 nasopharyngeal PCR tests are negative.
ECCO²² (European Crohn’s and Colitis Organization)	- Immunosuppressive and biological drugs should not be discontinued as a preventive strategy. - Discourage all nonessential travel and recommend protective aids. - Nonurgent outpatient visits should be postponed.		- The start of new biological drugs should be allowed if adequate protective measures can be guaranteed.	- The SARS-CoV-2 test should not be performed in IBD patients without symptoms.