{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:44:59Z","timestamp":1761129899735,"version":"3.41.2"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Junior Scientific Masterclass","award":["17-57 (to: ARB)"],"award-info":[{"award-number":["17-57 (to: ARB)"]}]},{"DOI":"10.13039\/501100001721","name":"rijksuniversiteit groningen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001721","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p> In the wake of the coronavirus disease 2019 (COVID-19) pandemic, it is unclear how asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected patients who present with acute severe ulcerative colitis (UC) can be treated effectively and safely. Standard treatment regimens consist of steroids, immunomodulatory drugs, and biological therapies, but therapeutic decision-making becomes challenging as there are uncertainties about how to deal with these drugs in patients with COVID-19 and active UC. Importantly, guidelines for this particular group of patients with UC are still lacking. To inform therapeutic decision-making, we describe three consecutive cases of patients with active UC and COVID-19 and discuss their treatments based on theoretical knowledge, currently available evidence and clinical observations. Three patients were identified through our national inflammatory bowel disease network [Initiative on Crohn\u2019s and Colitis (ICC)] for whom diagnosis of SARS-CoV-2-infection was established by reverse transcription\u2013polymerase chain reaction (RT-PCR) testing in nasopharynx, stools, and\/or biopsies. Acute severe UC was diagnosed by clinical parameters, endoscopy, and histopathology. Clinical guidelines for SARS-CoV-2-negative patients advocate the use of steroids, calcineurin inhibitors, or tumor necrosis factor alpha (TNF-\u03b1)-antagonists as induction therapy, and experiences from the current three cases show that steroids and TNF-\u03b1-antagonists could also be used in patients with COVID-19. This could potentially be followed by TNF-\u03b1-antagonists, vedolizumab, or ustekinumab as maintenance therapy in these patients. Future research is warranted to investigate if, and which, immunomodulatory drugs should be used for COVID-19 patients that present with active UC. To answer this question, it is of utmost importance that future cases of patients with UC and COVID-19 are documented carefully in international registries, such as the SECURE-IBD registry. <\/jats:p>","DOI":"10.1177\/17562848211012595","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T06:19:19Z","timestamp":1619763559000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Treatment of severe acute ulcerative colitis in SARS-CoV-2 infected patients: report of three cases and discussion of treatment options"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5754-3821","authenticated-orcid":false,"given":"Arno R.","family":"Bourgonje","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, 9700 RB, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinier C. A.","family":"van Linschoten","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel L.","family":"West","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten A.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Elkerliek Hospital, Helmond, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Coretta C.","family":"van Leer-Buter","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gursah","family":"Kats-Ugurlu","sequence":"additional","affiliation":[{"name":"Department of Pathology and Medical Biology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marieke J.","family":"Pierik","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Maastricht, University Medical Center Maastricht, Maastricht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora A. 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