COVID-19 Related

Patients with colonic IBD who have recently started therapy using agents such as biologics, JAK inhibitors, or azathioprine, should undergo endoscopy to assess the efficacy of treatment after 6–12 months. However, other tools could be used (eg, faecal calprotectin or bowel ultrasound). As such, endoscopic monitoring may not be essential.

A further risk is missed detection of early post-operative recurrence in patients with Crohn’s disease after ileocolonic surgery. Ileocolonoscopy to check the anastomosis site should be performed within 6–12 months after the surgery. Indirect tools, such as faecal calprotectin, bowel ultrasound, and magnetic resonance enterography, have been shown to be useful in disease monitoring and may help avoid endoscopy.

The IBDoc® is a simple tool to use and high satisfaction is found among IBDoc® users. IBD patients should be adequately informed and trained on the use of this test. FC home tests are an additional value for e-health approach in IBD patients. In the near future, these tests could allow not only tight monitoring of IBD patients but also their greater involvement in disease management.

When a COVID-minimised pathway is in place, patients (including those in a high risk “shielding” category) can now be reassured that concerns over COVID-19 infection should not stop them attending for GI endoscopy.

The BSG has given their expanded consensus advice for the management of IBD during the COVID-19 pandemic:

This survey shows the changes in how IBD clinics have been operating before and during the COVID pandemic and what is anticipated moving forward.

A UK online survey of 125 hospitals shows that key tools for monitoring and managing IBD patients were removed or restricted due the current COVID 19 situation.

This publications states that the ability to detect deteriorations in disease and react remotely will be important:

• IBD Apps for recording symptoms
• Faecal calprotectin should be incorporated into remote monitoring, ideally using home kits for sample acquisition

This pilot study explores a relation between GI symptoms, intestinal inflammation (determined by FC) and faecal SARS-CoV-2-RNA in hospitalised patients with COVID-19.