Inflammatory Bowel Disease Management During the COVID-19 Outbreak: The Ten Do’s and Don’ts from the ECCO-COVID Taskforce

Abstract

Our knowledge on COVID-19 is changing and evolving rapidly, with novel insights and recommendations, almost on a daily basis. It behooves the medical community to provide updated information on a regular basis, on best practice to facilitate optimal care of infected patients and appropriate advice for the general population. This is particularly important in the case of patients with chronic conditions, such as Inflammatory Bowel Disease (IBD). In this paper, we compiled the existing evidence on the impact of COVID-19 in IBD patients and provide guidance and on the most appropriate care to adopt during the pandemic. Our review highlighted that IBD, per se, is not a risk factor for COVID-19. However, all IBD patients with symptoms should be tested for SARS-CoV-2 and the procedures for disease management shall be carefully adapted: i) in SARS-CoV-2 positive IBD patients, medical treatments should be re-evaluated (with particular focus on corticosteroids) always with the purpose of treating active disease and maintaining remission; ii) non-urgent surgeries and endoscopic procedures should be postponed for all patients; iii) online consultancy should be implemented; and iv) hospitalization and surgery should be limited to life threatening situations

Depression, anxiety and stress among patients with inflammatory bowel disease during the COVID-19 pandemic: Australian national survey

“…Anxiety subscale scores correspond to normal population (0-7) mild, (8-9) moderate (10)(11)(12)(13)(14) and severe symptoms (15)(16)(17)(18)(19). Similarly, stress subscale scores corresponded to normal population (0-14), mild (15)(16)(17)(18), moderate (19)(20)(21)(22)(23)(24)(25) or severe symptoms (26)(27)(28)(29)(30)(31)(32)(33). Significant depression, anxiety and/or stress in our study was defined as at least moderate DASS21 subscores for depression, anxiety and/or stress.…”

“…Respondents score each item from 0 to 3, and item scores are added together and multiplied by 2 for each domain to generate three subscale scores. Depression subscale scores corresponds to normal population (0-9), mild (10)(11)(12)(13), moderate (14)(15)(16)(17)(18)(19)(20) and severe symptoms (21)(22)(23)(24)(25)(26)(27). Anxiety subscale scores correspond to normal population (0-7) mild, (8-9) moderate (10)(11)(12)(13)(14) and severe symptoms (15)(16)(17)(18)(19).…”

“…Depression subscale scores corresponds to normal population (0-9), mild (10)(11)(12)(13), moderate (14)(15)(16)(17)(18)(19)(20) and severe symptoms (21)(22)(23)(24)(25)(26)(27). Anxiety subscale scores correspond to normal population (0-7) mild, (8-9) moderate (10)(11)(12)(13)(14) and severe symptoms (15)(16)(17)(18)(19). Similarly, stress subscale scores corresponded to normal population (0-14), mild (15)(16)(17)(18), moderate (19)(20)(21)(22)(23)(24)(25) or severe symptoms (26)(27)(28)(29)(30)(31)(32)(33).…”

Concerns and attitudes of patients with inflammatory bowel diseases during the COVID-19 pandemic

“…Similar to other patient populations with chronic conditions, management of patients with in ammatory bowel diseases (IBD) had to adapt to the new situation that resulted from the pandemic. To facilitate clinical decisions, International IBD Societies [5] [6] published guidelines that covered regular follow-up, disease ares, endoscopy, treatment, hospital visits including infusion services, clinical trials, and implementation of telemedicine [7] [8]. Accordingly, IBD and GI-Units had to modify daily routines and practices, undertake speci c measures to maintain continuity of care, minimize patients' visits to hospitals and ensure adequate communication between patients and healthcare providers.…”

Inflammatory bowel disease service redesign during the COVID‐19 pandemic: Living, learning and delivering care amidst angst and uncertainty

“…Sharma and colleagues provide valuable insights into responsible and responsive service adaptation in the face of a global emergency. Even as a growing body of literature supports these initiatives, 3,4,6,7 their findings early in the pandemic need to be taken in context. They question our “pre‐pandemic” paradigms around aspects of health care delivery 8,9 .…”