ArticleGut2020
Adaptations to the British Society of Gastroenterology guidelines on the management of acute severe UC in the context of the COVID-19 pandemic: a RAND appropriateness panel.
Article in Gut, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 32 citations in OpenAlex.
- Management of Severe Ulcerative Colitis with Ambulatory Intravenous Corticosteroids (MOSAIC): A Treatment Approach to Avoid Hospitalization in Immunocompromised Patients.Crohn's & colitis 360 · 2025Article
- A case of relapsed pan-colonic ulcerative colitis accompanied with gastroduodenal lesions immediately after COVID-19.Clinical journal of gastroenterology · 2025Article
- Post-hospitalization Short Versus Long Steroid Taper Strategies in Patients With Acute Severe Ulcerative Colitis: A Comparison of Clinical Outcomes.Crohn's & colitis 360 · 2024Article
- Article
- Perception of COVID-19 Pandemic Among IBD Clinicians and IBD Surgeons in Black Sea Region: A Cross-Sectional Questionnaire Study.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022Article
- Thromboembolic Events in Patients with Inflammatory Bowel Disease: A Comprehensive Overview.Diseases (Basel, Switzerland) · 2022Review
- Efficacy and Safety of Elective Switching from Intravenous to Subcutaneous Infliximab [CT-P13]: A Multicentre Cohort Study.Journal of Crohn's & colitis · 2022Article
- Review
- Inflammatory bowel disease clinical service recovery during the COVID-19 pandemic.Frontline gastroenterology · 2022Article
- Management of inflammatory bowel disease in the COVID-19 era.Intestinal research · 2022Review
- Ambulatory care management of 69 patients with acute severe ulcerative colitis in comparison to 695 inpatients: insights from a multicentre UK cohort study.BMJ open gastroenterology · 2022Article
- Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA Appropriateness Method.Pharmacy (Basel, Switzerland) · 2021Article
- COVID-19: Effect on gastroenterology and hepatology service provision and training: Lessons learnt and planning for the future.World journal of gastroenterology · 2021Review
- Subtotal colectomy for refractory ulcerative colitis with COVID-19 infection; a first case report in Japan.Clinical journal of gastroenterology · 2021Article
- Comparative Outcomes of Budesonide MMX versus Prednisolone for Ulcerative Colitis: Results from a British Retrospective Multi-Centre Real-World Study.Journal of clinical medicine · 2021Article
- COVID-19 and the Use of Immunomodulatory Agents in OphthalmologyTurkish journal of ophthalmology · 2021Review
- Is SARS-CoV-2 screening test indicated for psoriasis patients candidate to biologic therapy?Journal of the European Academy of Dermatology and Venereology : JEADV · 2021Article
- Assessment, endoscopy, and treatment in patients with acute severe ulcerative colitis during the COVID-19 pandemic (PROTECT-ASUC): a multicentre, observational, case-control study.The lancet. Gastroenterology & hepatology · 2021Observational
- How to manage inflammatory bowel disease during the COVID-19 pandemic: A guide for the practicing clinician.World journal of gastroenterology · 2021Review
- Inflammatory bowel disease and risk of severe COVID-19: A nationwide population-based cohort study in Sweden.United European gastroenterology journal · 2021Article
Corrections and comments
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Authors and funding
34 authors at 20 institutions in 8 countries.
Funding
Abstract
objectiveManagement of acute severe UC (ASUC) during the novel COVID-19 pandemic presents significant dilemmas. We aimed to provide COVID-19-specific guidance using current British Society of Gastroenterology (BSG) guidelines as a reference point.
designWe convened a RAND appropriateness panel comprising 14 gastroenterologists and an IBD nurse consultant supplemented by surgical and COVID-19 experts. Panellists rated the appropriateness of interventions for ASUC in the context of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Median scores and disagreement index (DI) were calculated. Results were discussed at a moderated meeting prior to a second survey.
resultsPanellists recommended that patients with ASUC should be isolated throughout their hospital stay and should have a SARS-CoV-2 swab performed on admission. Patients with a positive swab should be discussed with COVID-19 specialists. As per BSG guidance, intravenous hydrocortisone was considered appropriate as initial management; only in patients with COVID-19 pneumonia was its use deemed uncertain. In patients requiring rescue therapy, infliximab with continuing steroids was recommended. Delaying colectomy because of COVID-19 was deemed inappropriate. Steroid tapering as per BSG guidance was deemed appropriate for all patients apart from those with COVID-19 pneumonia in whom a 4-6 week taper was preferred. Post-ASUC maintenance therapy was dependent on SARS-CoV-2 status but, in general, biologics were more likely to be deemed appropriate than azathioprine or tofacitinib. Panellists deemed prophylactic anticoagulation postdischarge to be appropriate in patients with a positive SARS-CoV-2 swab.
conclusionWe have suggested COVID-19-specific adaptations to the BSG ASUC guideline using a RAND panel.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.