J Pediatr Gastroenterol Nutr. 2020 Jun;70(6):727-733. doi: 10.1097/MPG.0000000000002729.

Dan Turner ¹, Ying Huang ², Javier Martín-de-Carpi ³, Marina Aloi ⁴, Gili Focht ¹, Ben Kang ⁵, Ying Zhou ², Cesar Sanchez ⁶, Michael D Kappelman ⁷, Holm H Uhlig ⁸, Gemma Pujol-Muncunill ³, Oren Ledder ¹, Paolo Lionetti ⁹, Jorge Amil Dias ¹⁰, Frank M Ruemmele ¹¹, Richard K Russell ¹², Paediatric IBD Porto group of ESPGHAN

Author information

¹Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel.

²Department of Gastroenterology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, China.

³Hospital Sant Joan de Déu, Barcelona, Spain.

⁴Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy.

⁵Kyungpook National University Children's Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

⁶Pediatric Gastrointestinal Unit H.G.U. Gregorio Maranon, Madrid, Spain.

⁷Pediatric Gastroenterology, University of North Carolina at Chapel Hill, Chapel Hill, NC.

⁸Translational Gastroenterology Unit, University of Oxford, Department of Paediatrics, John Radcliffe Hospital, University of Oxford, Biomedical Research Center Oxford, Oxford, UK.

⁹Departement NEUROFARBA - University of Florence - Meyer children's Hospital - Florence, Florence, Italy.

¹⁰Pediatric Gastroenterology, Centro Hospitalar Universitário S. João, Porto, Portugal.

¹¹Université Paris Descartes, Sorbonne Paris Cité, APHP, Hôpital Necker Enfants Malades, Paris, France.

¹²Department of Paediatric Gastroenterology, The Royal Hospital for Sick Children, Edinburgh, UK.

PMID: 32443020

 PMCID: PMC7273950

 DOI: 10.1097/MPG.0000000000002729

Free PMC article

Abstract

Introduction: With the current coronavirus disease 2019 (COVID-19) pandemic, concerns have been raised about the risk to children with inflammatory bowel diseases (IBD). We aimed to collate global experience and provide provisional guidance for managing paediatric IBD (PIBD) in the era of COVID-19.

Methods: An electronic reporting system of children with IBD infected with SARS-CoV-2 has been circulated among 102 PIBD centres affiliated with the Porto and Interest-group of ESPGHAN. A survey has been completed by major PIBD centres in China and South-Korea to explore management during the pandemic. A third survey collected current practice of PIBD treatment. Finally, guidance points for practice have been formulated and voted upon by 37 PIBD authors and Porto group members.

Results: Eight PIBD children had COVID-19 globally, all with mild infection without needing hospitalization despite treatment with immunomodulators and/or biologics. No cases have been reported in China and South Korea but biologic treatment has been delayed in 79 children, of whom 17 (22%) had exacerbation of their IBD. Among the Porto group members, face-to-face appointments were often replaced by remote consultations but almost all did not change current IBD treatment. Ten guidance points for clinicians caring for PIBD patients in epidemic areas have been endorsed with consensus rate of 92% to 100%.

Conclusions: Preliminary data for PIBD patients during COVID-19 outbreak are reassuring. Standard IBD treatments including biologics should continue at present through the pandemic, especially in children who generally have more severe IBD course on one hand, and milder SARS-CoV-2 infection on the other.