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  http://covidibd.org  registry update.
1/

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".
2/

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.
3/

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
4/

▶️Patients should stay on their therapies and stay in remission.
▶️Having a flare may make infection risk higher, but also will strain healthcare resources
5/

▶️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
6/

▶️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.)
7/

▶️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
8/

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.
9/

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

,


You can follow @IBDMD.



Bookmark

____
Tip: mention @threader_app on a Twitter thread with the keyword “compile” to get a link to it.

Threader is an independent, ad-free project created by two developers. Our iOS Twitter client was featured as an App of the Day by Apple. Sign up today to compile, bookmark and archive your favorite threads.

Follow Threader