Gut. 2020 Jun;69(6):984-990. doi: 10.1136/gutjnl-2020-321244.Epub 2020 Apr 17.

Nicholas A Kennedy ^1 2, Gareth-Rhys Jones ^3 4, Christopher A Lamb ^5 6, Richard Appleby ⁷, Ian Arnott ⁴, R Mark Beattie ⁸, Stuart Bloom ⁹, Alenka J Brooks ¹⁰, Rachel Cooney ^11 12, Robin J Dart ^13 14, Cathryn Edwards ¹⁵, Aileen Fraser ¹⁶, Daniel R Gaya ^17 18, Subrata Ghosh ^11 12, Kay Greveson ¹⁴, Richard Hansen ^18 19, Ailsa Hart ^20 21, A Barney Hawthorne ²², Bu'Hussain Hayee ^13 23, Jimmy K Limdi ^24 25, Charles D Murray ¹⁴, Gareth C Parkes ^26 27, Miles Parkes ²⁸, Kamal Patel ²⁹, Richard C Pollok ^29 30, Nick Powell ^21 31, Chris S Probert ^32 33, Tim Raine ²⁸, Shaji Sebastian ³⁴, Christian Selinger ³⁵, Philip J Smith ³², Catherine Stansfield ³⁶, Lisa Younge ³⁷, James O Lindsay ^26 27, Peter M Irving ^13 38, Charlie W Lees ^39 4

Author information

¹Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.

²University of Exeter, Exeter, UK.

³University of Edinburgh, Edinburgh, UK.

⁴Western General Hospital, Edinburgh, UK.

⁵Newcastle University, Newcastle upon Tyne, UK.

⁶Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

⁷Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.

⁸Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

⁹University College London Hospitals NHS Foundation Trust, London, UK.

¹⁰Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

¹¹Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, UK.

¹²University of Birmingham, Birmingham, UK.

¹³King's College London, London, UK.

¹⁴The Royal Free Hospital, London, UK.

¹⁵Torbay and South Devon NHS Foundation Trust, Torquay, UK.

¹⁶University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

¹⁷Glasgow Royal Infirmary, Glasgow, UK.

¹⁸University of Glasgow, Glasgow, UK.

¹⁹Royal Hospital for Children, Glasgow, UK.

²⁰St Mark's Hospital, London, UK.

²¹Imperial College London, London, UK.

²²University Hospital of Wales, Cardiff, UK.

²³King's College Hospital NHS Foundation Trust, London, UK.

²⁴The Pennine Acute Hospitals NHS Trust, Manchester, UK.

²⁵University of Manchester, Manchester, UK.

²⁶Barts and the London School of Medicine and Dentistry, London, UK.

²⁷The Royal London Hospital, Barts Health NHS Trust, London, UK.

²⁸Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

²⁹St George's University Hospitals NHS Foundation Trust, London, UK.

³⁰St George's, University of London, London, UK.

³¹Imperial College Healthcare NHS Trust, London, UK.

³²Liverpool University Hospitals NHS Foundation Trusts, Liverpool, UK.

³³University of Liverpool, Liverpool, UK.

³⁴Hull University Teaching Hospitals NHS Trust, Hull, UK.

³⁵Leeds Teaching Hospitals NHS Trust, Leeds, UK.

³⁶Salford Royal NHS Foundation Trust, Salford, UK.

³⁷Crohn's and Colitis UK, St Albans, Hertfordshire, UK.

³⁸Guy's and St Thomas' NHS Foundation Trust, London, UK.

³⁹University of Edinburgh, Edinburgh, UK charlie.lees@ed.ac.uk.

Abstract

The COVID-19 pandemic is putting unprecedented pressures on healthcare systems globally. Early insights have been made possible by rapid sharing of data from China and Italy. In the UK, we have rapidly mobilised inflammatory bowel disease (IBD) centres in order that preparations can be made to protect our patients and the clinical services they rely on. This is a novel coronavirus; much is unknown as to how it will affect people with IBD. We also lack information about the impact of different immunosuppressive medications. To address this uncertainty, the British Society of Gastroenterology (BSG) COVID-19 IBD Working Group has used the best available data and expert opinion to generate a risk grid that groups patients into highest, moderate and lowest risk categories. This grid allows patients to be instructed to follow the UK government's advice for shielding, stringent and standard advice regarding social distancing, respectively. Further considerations are given to service provision, medical and surgical therapy, endoscopy, imaging and clinical trials.