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2.
Chirurg ; 92(1): 30-33, 2021 Jan.
Article in German | MEDLINE | ID: covidwho-976992

ABSTRACT

In order to improve the care of patients with chronic inflammatory bowel diseases during the coronavirus disease 2019 (COVID-19) pandemic, the currently valid guidelines of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) on Crohn's disease and ulcerative colitis were extended within a virtual conference to include current and practically relevant recommendations. The addendum addresses in particular the risk of COVID-19 infections in patients with chronic inflammatory bowel diseases, the diagnostics under the conditions of the pandemic, the consequences for the pharmacotherapy and operative treatment of the underlying disease. It also addresses general measures for protection against infections and for adjunctive treatment of patients with chronic inflammatory bowel diseases.


Subject(s)
COVID-19 , Colitis, Ulcerative , Crohn Disease , Inflammatory Bowel Diseases , Humans , Pandemics , SARS-CoV-2
3.
Z Gastroenterol ; 58(10): 982-1002, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-886826

ABSTRACT

The COVID-19 pandemic is a global outbreak of new onset infections with the SARS-CoV-2 virus. To date, more than 3.4 million people have been infected throughout the world. In Germany, approximately 450,000 patients suffer from inflammatory bowel disease; these patients generally require continuous expert care and support. Against the background of a rapidly accumulating knowledge base on SARS-CoV-2, 68 expert authors of the current DGVS guidelines for Crohn's disease and ulcerative colitis took part in a virtual meeting to compile up-to-date, practice-orientated recommendations aimed at improving the care of patients with IBD. These recommendations address the risk of infection, including the risk for specific patient groups, the possible course of the disease, and consequences for pharmacological and surgical therapies of the underlying disease, as well as general measures for infection prevention and adjuvant prophylactic and therapeutic options.


Subject(s)
Colitis, Ulcerative , Coronavirus Infections , Crohn Disease , Inflammatory Bowel Diseases , Pneumonia, Viral , Practice Guidelines as Topic , Betacoronavirus , COVID-19 , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/therapy , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Crohn Disease/diagnosis , Crohn Disease/therapy , Germany , Humans , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/therapy , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2
5.
J Crohns Colitis ; 14(12): 1765-1768, 2020 Dec 02.
Article in English | MEDLINE | ID: covidwho-614015

ABSTRACT

The intense competition for resources to combat COVID-19 has greatly reduced access to health care for patients with other diseases. After the disastrous overrun of hospitals through COVID-19 patients in some jurisdictions, availability of resources for 'elective' medical procedures, including care for the chronically ill, has been greatly reduced in many places as a pre-emptive measure before or during the blooming of infection clusters. Pharmaceutical companies have either stopped recruitment or even cancelled ongoing clinical trials in chronic diseases. Pre-emptive triage and its impact on medical ethics is discussed in the framework of care for inflammatory bowel disease.


Subject(s)
Anti-Inflammatory Agents/therapeutic use , COVID-19/prevention & control , Clinical Trials as Topic/ethics , Drug Development/ethics , Health Care Rationing/ethics , Health Services Accessibility/ethics , Inflammatory Bowel Diseases/drug therapy , COVID-19/epidemiology , Chronic Disease , Global Health , Humans , Pandemics/prevention & control , Triage/ethics , Triage/methods
6.
J Gastroenterol Hepatol ; 35(7): 1117-1123, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-574632

ABSTRACT

The available COVID-19 literature has focused on specific disease manifestations, infection control, and delivery or prioritization of services for specific patient groups in the setting of the acute COVID-19 pandemic. Local health systems aim to contain the COVID-19 pandemic and hospitals and health-care providers rush to provide the capacity for a surge of COVID-19 patients. However, the short, medium-term, and long-term outcomes of patients with gastrointestinal (GI) diseases without COVID-19 will be affected by the ability to develop locally adapted strategies to meet their service needs in the COVID-19 setting. To mitigate risks for patients with GI diseases, it is useful to differentiate three phases: (i) the acute phase, (ii) the adaptation phase, and (iii) the consolidation phase. During the acute phase, service delivery for patients with GI disease will be curtailed to meet competing health-care needs of COVID-19 patients. During the adaptation phase, GI services are calibrated towards a "new normal," and the consolidation phase is characterized by rapid introduction and ongoing refinement of services. Proactive planning with engagement of relevant stakeholders including consumer representatives is required to be prepared for a variety of scenarios that are dictated by thus far undefined long-term economic and societal impacts of the pandemic. Because substantial changes to the delivery of services are likely to occur, it is important that these changes are embedded into quality and research frameworks to ensure that data are generated that support evidence-based decision-making during the adaptation and consolidation phases.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Gastroenterology/organization & administration , Gastrointestinal Diseases/therapy , Health Services Accessibility/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , SARS-CoV-2
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