Table 1 Proposed IBD endoscopy recommendations during the COVID-19 outbreak from Humanitas and the SFED
From: SFED recommendations for IBD endoscopy during COVID-19 pandemic: Italian and French experience
Setting | Proposed recommendation | Proposed solution |
|---|---|---|
General recommendation | Correct PPE for patients and HCPs | Checkpoints at the hospital or unit entrance Correct PPE: mask, gloves, hairnet, gown, hand disinfection |
Endoscopy for monitoring of disease activity | Check clinical activity and use non-invasive tests | Phone call at home by dedicated staff and faecal calprotectin test at home |
Acute severe ulcerative colitis | Accurate differential diagnosis, biopsies | Maintain proctosigmoidoscopy |
Postoperative recurrence assessment | Reschedule the endoscopic exam for after the end of pandemic emergency | In symptomatic patients, replace endoscopy with faecal calprotectin tests and/or bowel ultrasonography |
Endoscopy for screening of dysplasia | Reschedule the endoscopic exam for after the end of pandemic emergency | No specific markers are available to avoid endoscopy |
Endoscopic dilatation | To be performed if severe and disabling obstructive symptoms are present | Management of patients in dedicated IBD centres to avoid surgery |
Endoscopic procedures for mild–moderate disease: Crohn’s disease and ulcerative colitis | Limit procedures to decrease the risk of SARS-CoV-2 transmission to the patient and/or staff | Monitor disease with PROs, faecal calprotectin home tests |
Endoscopic procedure for moderate–severe disease: ulcerative colitis | Maintain endoscopic procedure in situations that will lead to a therapeutic change: confirmation of IBD diagnosis, confirmation severe flare | Preference for proctosigmoidoscopy to colonoscopy |
Endoscopic procedure for moderate–severe disease: Crohn’s disease | Maintain endoscopic procedure in situations that will lead to a therapeutic change: confirmation of IBD diagnosis, confirmation severe flare | In first Crohn’s disease diagnosis: first screen with CT or MRE, then confirm with colonoscopy and biopsies If Crohn’s disease is already known: evaluate for faecal calprotectin tests and/or MRE or bowel ultrasonography |
