Sebastian S, Walker GJ, Kennedy NA, et al. - In this multicenter, observational, case-control study (PROTECT-ASUC), researchers identified changes to established conventional evidence-based management of acute severe ulcerative colitis early on in the COVID-19 pandemic in the UK, to assess the impact on patient outcomes, and COVID-19 acquisition and severity. The sample consisted of 782 patients (398 in the pandemic period cohort and 384 in the historical control cohort) who met the Truelove and Witts criteria for acute severe ulcerative colitis. In the management of acute severe ulcerative colitis, the COVID-19 pandemic changed practice patterns of gastroenterologists and colorectal surgeons but was correlated with comparable outcomes to a historical cohort. The occurrence of COVID-19 within 3 months was minimal and not associated with adverse COVID-19 outcomes, despite the persistent use of high-dose corticosteroids and biologicals. During the pandemic, the proportion of patients receiving rescue therapy (including primary induction) or surgery was greater vs the historical period; the time to rescue therapy was shorter in the pandemic cohort vs the historical cohort. More patients received ambulatory (outpatient) intravenous steroids and fewer patients received thiopurines and 5-aminosalicylic acids during the pandemic. Laparoscopic surgery was done less frequently during the pandemic period.