CORNAVIRUS ADVICE FOR IBD PATIENTS – updated 17/3/2020
For most people coronavirus (COVID-19) will be a mild illness.
This has been discussed with our consultants and senior IBD CNS and this is our current guidance, please be aware this is an evolving situation;
Having IBD does not put you in a high risk group, so if you are on no medications for it, are on topical therapy only, or oral mesalasine (Salofalk, asacol, pentasa, octasa) then you are not considered to be in a vulnerable group and should follow guidance for the general public.
Patients on immune suppression and biologics
(Azathioprine, Mercaptopurine, Methotrexate, Adalimumab, Infliximab, Vedolizumab, Tofacitinib, Ustekinumab)
It appears that you are at NO increased risk of getting coronavirus being on any of these medications. Immune suppression can increase the risk slightly of having more severe symptoms if you were to catch it, however most severe cases have been in the over 70s and those with other health conditions. We strongly feel you are much better to remain on medications and remain well in yourself.
If you stop your medications you then have a risk of flaring up and a high chance of needing steroids (which also supress the immune system) or if severe needing admission to hospital. If you were then to catch coronavirus you would be in a much worse position to fight it than if you catch it when you are otherwise well and on your medications.
You should follow basic hygiene rules and good handwashing.
We cannot give individual advice on whether you should work from home; you should discuss this with your employer and occupational health if you have this available to you. You can look at most recent guidance on social distancing on the government website www.gov.uk then click on covid-19, then scroll down and click on guidance on social distancing and for vulnerable people. This is the same information we have and we advise you to read it and make a decision from that. If you are on immunosuppression and/or biologic you are considered a vulnerable person.
There is also guidance on the government website for employees and employers.
If you are on high dose steroids (over Prednisolone 20mg per day) or are on steroids plus biologic plus azathioprine/mercaptopurine we consider you at a slightly higher risk and you may want to apply social distancing measures more stringently.
Patients on biologic infusions should still attend, if you are over 70 and /or have other health conditions such as diabetes, chest problems, heart problems then please let your IBD nurse know
You can also look at information provided on www.crohnsandcolitis.org.uk
If you feel you have symptoms of coronavirus such as high temperature over 37.8 degrees Celsius, or new continuous dry cough (i.e. coughing repeatedly) you need to self isolate for 7days (if you live alone) or if you live with others the whole household needs to self isolate for 14 days as per government advice (you can find specifics on what this involves on the 111 NHS website mentioned below or the gov.uk website mentioned above.
Other symptoms can be shortness of breath.
If these symptoms are mild and flu like you should continue all of your IBD medications.
If you have severe symptoms or feel unable to cope with your symptoms at home you should look at the NHS 111 website; www.111.nhs.uk (or call 111 ONLY if you cannot access their website for advice), they may advise you on your medications and we recommend following any advice they give you.