Early in the pandemic, there was significant concern about how COVID-19 may impact patients
with inflammatory bowel disease (IBD). Would IBD, as a chronic immune-mediated condition, be
a risk factor for more severe COVID-19? Would medications used to treat IBD, in particularly
immunosuppressants, increase the likelihood of hospitalization or death due to COVID-19?
However, at the start of the pandemic there was a paucity of data to guide decision making for
patients with IBD. In this setting, many national and international societies issued statements on
management of IBD to provide initial guidance to gastroenterologists and patients with IBD. The
British Society of Gastroenterology (BSG) published an IBD risk grid for COVID-19 severity in
April 2020 that proposed a framework for categorizing patients with IBD into those more likely to
be vulnerable to COVID-19 primarily based on co-morbidities and disease characteristics.
Patients deemed at moderate risk were advised to practice stringent social distancing while those
at high risk were recommended to practice “shielding,” the strictest advice for isolating from
others. The authors of the BSG IBD risk grid recently issued a statement withdrawing this
guidance noting a number of factors including that the vast majority of IBD patients are not at
increased risk of adverse COVID-19 outcomes, the reduced severity of disease with recent
variants, and the effectiveness of COVID-19 vaccines
