• Aysha H Al-Ani, Ralley E Prentice, Clarissa A Rentsch, Doug Johnson, Zaid Ardalan, Neel Heerasing, Mayur Garg, Sian Campbell, Joe Sasadeusz, Finlay A Macrae, Siew C Ng, David T Rubin, and Britt Christensen.
• Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Vic., Australia.
• Aliment. Pharmacol. Ther. 2020 Jul 1; 52 (1): 54-72.

BackgroundThe current COVID-19 pandemic, caused by SARS-CoV-2, has emerged as a public health emergency. All nations are seriously challenged as the virus spreads rapidly across the globe with no regard for borders. The primary management of IBD involves treating uncontrolled inflammation with most patients requiring immune-based therapies. However, these therapies may weaken the immune system and potentially place IBD patients at increased risk of infections and infectious complications including those from COVID-19.AimTo summarise the scale of the COVID-19 pandemic, review unique concerns regarding IBD management and infection risk during the pandemic and assess COVID-19 management options and drug interactions in the IBD population.MethodsA literature review on IBD, SARS-CoV-2 and COVID-19 was undertaken and relevant literature was summarised and critically examined.ResultsIBD patients do not appear to be more susceptible to SARS-CoV-2 infection and there is no evidence of an association between IBD therapies and increased risk of COVID-19. IBD medication adherence should be encouraged to prevent disease flare but where possible high-dose systemic corticosteroids should be avoided. Patients should exercise social distancing, optimise co-morbidities and be up to date with influenza and pneumococcal vaccines. If a patient develops COVID-19, immune suppressing medications should be withheld until infection resolution and if trial medications for COVID-19 are being considered, potential drug interactions should be checked.ConclusionsIBD patient management presents a challenge in the current COVID-19 pandemic. The primary focus should remain on keeping bowel inflammation controlled and encouraging medication adherence.© 2020 John Wiley & Sons Ltd.

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