Worldwide Management of Inflammatory Bowel Disease During the COVID-19 Pandemic: An International Survey

Inflamm Bowel Dis. 2020 Aug 14;izaa202. doi: 10.1093/ibd/izaa202. Online ahead of print.

Charles N Bernstein 1, Siew C Ng 2, Rupa Banerjee 3, Flavio Steinwurz 4, Bo Shen 5, Franck Carbonnel 6, Saeed Hamid 7, Ajit Sood 8, Jesus K Yamamoto-Furusho 9, Anne Griffiths 10, Eric I Benchimol 11, Simon Travis 12, Susana Lopes 13, David T Rubin 14, Gilaad G Kaplan 15, David Armstrong 16, Richard Gearry 17, IBD-Emerging Nations Consortium and the WGO IBD Task Force on COVID-19


  • IBD-Emerging Nations Consortium and the WGO IBD Task Force on COVID-19: M Masudur Rahman, Mostafa N Mohsin, Andrea Vieira, Nayara Carvalho Salgado, Marta Brenner Machado, Hao Wu, Joyce W Y Mak, Ying-Lei Miao, Murdani Abdullah, Yehuda Chowers, Elly Ogutu, Smita Devani, Suk-Kyun Yang, Mahmoud Omar, K L Goh, Ida Hilmi, Raja Affendi Raja Ali, Than Than Aye, Tin Moe Wai, Neeraj Joshi, Zaigham Abbas, Fernando Magro, Jose Sollano, Esther A Torres, Syed Adnan Mohiuddin, Mircea Diculescu, Majid Almadi, David Ong, Gillian Watermeyer, Navarathne Metthananda, Shuchen Wei, Julajak Limsrivilai, Nonthalee Pausawasdi, Pises Pisepongsa, Gursimran Kochhar, Ximena Rodríguez, Dao Viet


Author information

  • 1University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba, Canada.
  • 2Department of Medicine and Therapeutics, Institute of Digestive Disease, LK Institute of Health Science, The Chinese University of Hong Kong, Hong Kong, China.
  • 3Asian Institute of Gastroenterology, Hyderabad, India.
  • 4Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
  • 5Columbia University Irving Medical Center, New York, NY, USA.
  • 6Service de Gastroentérologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris Saclay, Le Kremlin-Bicêtre, France.
  • 7Aga Khan University, Karachi, Pakistan.
  • 8Dayanand Medical College and Hospital, Ludhiana, India.
  • 9National Institute of Medical Sciences and Nutrition, Mexico City, Mexico.
  • 10Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
  • 11Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
  • 12Translational Gastroenterology Unit, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.
  • 13Centro Hospitalar e Universitário São João, Porto, Portugal.
  • 14University of Chicago, Chicago, Illinois, USA.
  • 15University of Calgary, Calgary, Alberta, Canada.
  • 16McMaster University Medical Centre, Hamilton, Ontario, Canada.
  • 17Department of Medicine, University of Otago, Christchurch, New Zealand.


Background and aims: Persons with inflammatory bowel disease (IBD) may be particularly vulnerable to COVID-19 either because of their underlying disease or its management. Guidance has been presented on the management of persons with IBD in the time of this pandemic by different groups. We aimed to determine how gastroenterologists around the world were approaching the management of IBD.

Methods: Members of the World Gastroenterology Organization (WGO) IBD Task Force contacted colleagues in countries largely beyond North America and Europe, inviting them to review the WGO website for IBD and COVID-19 introduction, with links to guideline documents, and then to respond to 9 ancillary open-ended management questions.

Results: Fifty-two gastroenterologists from 33 countries across 6 continents completed the survey (April 14 to May 16, 2020). They were all adhering for the most part to published guidelines on IBD management in the COVID-19 era. Some differences and reductions in services related to access, and some related to approach within their communities in terms of limiting virus spread. In particular, most gastroenterologists reduced in-person clinics (43 of 52), limited steroid use (47 of 51), limited elective endoscopy (45 of 52), and limited elective surgeries (48 of 51). If a patient was diagnosed with COVID-19, immunomodulatory therapy was mostly held.

Conclusions: In most countries, the COVID-19 pandemic significantly altered the approach to persons with IBD. The few exceptions were mostly based on low burden of COVID-19 in individual communities. Regardless of resources or health care systems, gastroenterologists around the world took a similar approach to the management of IBD.

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