Note: This thread is related to #COVID19.

Follow the World Health Organization's instructions to reduce your risk of infection. Avoid the three Cs: Crowded places, Close Contact Settings & Confined spaces. Airborne aerosols play an important role in transmitting COVID-19.

- Avoid crowded places and limit time in enclosed spaces

- Apply social distance

- Air rooms by opening windows & doors

- Keep hands and surfaces clean, cover coughs & sneezes

- Wear a mask when you are not at home or when physical distancing is not possible

David T. Rubin, MD
+ Your AuthorsArchive @IBDMD Professor and Chief of GI, The University of Chicago Medicine. I specialize in and advocate for the care of IBD patients. My tweets are my own. (he/him) Mar. 20, 2020 2 min read

20 March update on #IBD and #COVID19
(a Tweetorial in 10 parts)
Just finished an #IOIBD webinar with 87 international experts, including immunologists, pathologists and GIs.
▶️We heard from epicenters in China, Hong Kong, Italy and the  registry update.

On this 3 hour call, we compared experiences and reviewed the results of a pre-call survey (RAND panel) assessing the appropriateness of #COVID19 risk and #IBD treatments. The experts rated statements from 1-9, with 1-"completely appropriate" to 9- "completely inappropriate".

The plan is for a follow-up survey (RAND panel) this weekend after our group discussion, but I will share some of the early consensus items with you. We DO plan to share broadly the entire set of results soon, and publish (quickly) to disseminate.

Expert consensus:
▶️Having #IBD is not a risk factor for #SARSCoV2 infection or #COVID19
▶️There is not a difference between #Crohns and #UC in risk of #SARSCoV2 and #COVID19
▶️Having active inflammation MAY increase risk of infection via multiple possible mechanisms

▶️Patients should stay on their therapies and stay in remission.
▶️Having a flare may make infection risk higher, but also will strain healthcare resources

▶️Diarrhea is a common symptom in patients w #COVID19 and in the small number of #IBD cases reported so far
▶️There is detectable #SARSCoV2 in stool, but it's orders of magnitude less than the nasopharynx
▶️Fecal-oral transmission is not confirmed, but caution advised

▶️Infusion centers *with an appropriate screening protocol* are ok
▶️Elective switching from IV to injection therapy is not recommended at this time
▶️Safety of home infusions is uncertain. (An infected RN could be less safe than an experienced and secure infusion center.)

▶️Delay/postpone all non-essential endoscopic procedures
▶️Prednisone is not recommended, may increase risk of infection
▶️Getting off prednisone safely is generally advised, but especially if a patient has exposure or is #SARSCoV2 positive

We also discussed other classes of #IBD therapy in the setting of #SARSCoV2 infection and #COVID19 but the consensus opinions will come after the second survey (RAND panel) and be shared very soon.

It is obvious that the worldwide #IBD community is very close and we all got strength from being "together" today and learning from each another. It is a privilege to work with such amazing colleagues.
Stay tuned. Stay safe. #IBDstrong #IOIBD
10/10 fin


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