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Background and purpose: Multisystem Inflammatory Syndrome in Children (MIS-C) occurs after having COVID-19. The severity and outcomes of COVID-19 with gastrointestinal symptoms are higher. The aim of this study was to investigate gastrointestinal manifestations in MIS-C patients in selected referral hospitals in Iran to obtain comprehensive information about the treatment and prevention of MIS-C. Materials and methods: In this cross-sectional study, all MIS-C patients <21 years in Dec 2019 to Oct 2021 were included. The patients were identified by the Centers for Disease Control and Prevention (CDC) checklist and data were analyzed applying t-test and Chi-square in STATA11. Results: There were 225 patients with a median age of 55 months (26-96 months), including 59.56% boys and all had fever on admission. At least one gastrointestinal symptom was seen in 200 patients and the most common symptoms were vomiting (60.9%) and abdominal pain (45.77%). Almost 60% of the patients had positive RT-PCR results. Among the patients with and without gastrointestinal symptoms 85.5% and 48% were admitted to intensive care unit (ICU), respectively. There were significant differences between the two groups in respiratory symptoms, ALT, AST, NT-pro BNP, ESR, and PLT (P < 0.05). All patients without gastrointestinal symptoms were discharged but nine patients in the group with gastrointestinal symptoms deceased. Conclusion: According to the current study, gastrointestinal symptoms are common in MIS-C patients and are associated with higher rates of death and intensive care unit admission. Therefore, in providing services to COVID-19 patients, all typical and atypical signs and symptoms should be considered to prevent unnecessary interventions.
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Background: Clostridium spp. spores are resistant to many factors, including alcohol-based disinfectants. The presence of clostridial spores in a hospital environment may lead to infection outbreaks among patients and health care workers. Background: This study is aimed to detect clostridial spores in the aurology hospital using C diff Banana BrothTM and assess the antibiotic sensitivity and toxinotypes of isolates. Methods: After diagnosing COVID-19 in medical staff and closing an 86-bed urology hospital in 2020 for H2O2 fogging, 58 swabs from the hospital environment were inoculated to C diff Banana BrothTM, incubated at 37 degrees C for 14 days, checked daily, and positive broths were sub-cultured anaerobically for 48 h at 37 degrees C. After identification, multiplex PCR (mPCR) was performed for Clostridium perfringens, C. difficile toxin genes, and minimum inhibitory concentration (MIC) determination. Results: In this study, 16 out of 58 (~ 28%) strains of Clostridium spp. were cultured: 11 - C. perfringens, 2 - C. baratii, and 1 each of C. paraputrificum, C. difficile, and C. clostridioforme. 11 C. perfringens were positive for the cpa, 7 - the cpb2, 2 - cpiA, and 1 - cpb toxin genes. All isolates were sensitive to metronidazole, vancomycin, moxifloxacin, penicillin/tazobactam, and rifampicin. Two out of the 11 C. perfringens strains were resistant to erythromycin and clindamycin. Conclusions: Regardless of the performed H2O2 fogging, antibiotic-resistant, toxigenic strains of C. perfringens (69%) obtained from the urology hospital environment were cultured using C diff Banana BrothTM, indicating the need to develop the necessary sanitary and epidemiological procedures in this hospital.
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Nucleic acid (NA) therapy has gained importance over the past decade due to its high degree of selectivity and minimal toxic effects over conventional drugs. Currently, intravenous (IV) or intramuscular (IM) formulations constitute majority of the marketed formulations containing nucleic acids. However, oral administration is traditionally preferred due to ease of administration as well as higher patient compliance. To leverage the benefits of oral delivery for NA therapy, the NA of interest must be delivered to the target site avoiding all degrading and inhibiting factors during its transition through the gastrointestinal tract. The oral route presents myriad of challenges to NA delivery, making formulation development challenging. Researchers in the last few decades have formulated various delivery systems to overcome such challenges and several reviews summarize and discuss these strategies in detail. However, there is a need to differentiate between the approaches based on target so that in future, delivery strategies can be developed according to the goal of the study and for efficient delivery to the desired site. The goal of this review is to summarize the mechanisms for target specific delivery, list and discuss the formulation strategies used for oral delivery of NA therapies and delineate the similarities and differences between local and systemic targeting oral delivery systems and current challenges.
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Background: Gastrointestinal bleeding is one of the consequences of COVID-19, which is associated with increased hospitalization and patient mortality. This study was conducted to determine the prevalence of endoscopic findings and the outcome of gastrointestinal bleeding in patients with COVID-19 who were hospitalized from September to December 2019 in Al-Zahra Hospital, Isfahan. Methods: In this cross-sectional study, out of 5800 patients who were admitted to Al- Zahra Hospital in Isfahan from September to December 2019 due to COVID-19 (according to the positive PCR test result), 87 patients who underwent endoscopy due to upper gastrointestinal bleeding by a skilled gastroenterologist, were selected and studied. Demographic characteristics, underlying diseases, use of anticoagulants, and laboratory findings were studied and evaluated and finally, the disease was evaluated and compared based on endoscopic findings. Results: Based on the results obtained from this research, the patients with endoscopic lesions had higher average age (P=0.041), lower blood oxygen saturation percentage (P=0.028), and higher bleeding intensity (P=0.018). The frequency of using anticoagulant drugs in the group whose endoscopy results were abnormal was higher but insignificant. Hemoglobin, platelet, lymphocyte, and CRP levels were higher in the group whose endoscopy was normal, and NLR, LDH, and D-dimer levels were higher in the group whose endoscopy was abnormal (P<0.050). Three people (11.55%) from the group with normal endoscopy and 18 people (29.5%) from the group with abnormal endoscopy died, but the frequency of death was not significantly different between the two groups (P=0.070). Conclusion: The findings of the present study showed that the COVID patients with upper gastrointestinal bleeding who had endoscopic lesions had significant differences in some characteristics such as age, bleeding intensity, and blood oxygen saturation percentage with patients with normal endoscopy. Also, the frequency of death in patients with endoscopic lesions was relatively higher. Therefore, COVID patients with gastrointestinal bleeding should undergo endoscopy as soon as possible and necessary measures should be taken to control and prevent gastrointestinal bleeding.
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Coinfection caused by bacteria, parasites, or viruses complicates almost all feline panleukopenia virus (FPV) infections. Pathogens that colonize the gastrointestinal tract, Clostridium perfingens, Clostridium piliforme, Cryptosporidium spp, Giardia spp, Tritrichomonas fetus, canine parvovirus type 2,Salmonella sp., feline coronavirus, feline bocavirus, and feline astrovirus were isolated in the presence of FPV infection. Complex mechanisms between viruses, bacteria, protozoa, and hosts contribute to the pathogenesis and severity of coinfection. Prompt and accurate diagnosis, vaccination precautions, and appropriate treatment play important roles in reducing morbidity and mortality. This article outlines the etiology, pathogenesis, diagnosis, prevention, and treatment that can help veterinarians and pet owners improve their knowledge of managing the diseases.
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Infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) can cause a variety of gastroenterological symptoms. A relevant proportion of patients complain of symptoms typical of gastroenteritis;the number of patients affected by gastroenterological symptoms has increased with the spread of the omicron variants. Furthermore, there are also signs of liver involvement in infected people. In the acute phase, increased liver enzymes and acute decompensation of pre-existing liver disease are observed, which can deteriorate into acute-on-chronic liver failure. Long-term sequelae of a SARS-CoV-2 infection must be distinguished from this. These sequelae can manifest either as direct infection- or therapy-associated sequelae, such as the development of secondary sclerosing cholangitis after intensive care therapy or as symptoms in the context of a post-coronavirus disease (COVID) syndrome. The pathophysiology leading to the development of a post-COVID syndrome is still unclear;here, the influence of the intestinal microbiome is discussed. This review article presents acute gastroenterological symptoms and long-term sequelae of a SARS-CoV-2 infection, which we are increasingly confronted with in clinical practice.Copyright © 2023, The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.
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Background: WHO has declared Coronavirus 2019 (COVID-19) as pandemic on 11th March 2020. Hydroxychloroquine (HCQ) chemoprophylaxis has been approved by the Indian Council of Medical Research (ICMR) for asymptomatic healthcare workers treating suspected or confirmed COVID-19 cases and asymptomatic household contacts of confirmed patients. However, there is a scarcity of data regarding the efficacy and safety of HCQ for COVID-19 prophylaxis and treatment. Background: The present study was designed to evaluate the adverse drug reaction (ADR) profile of HCQ prophylaxis among healthcare workers in a tertiary care teaching hospital in India. Methods: A Descriptive cross-sectional study was conducted in Kalpana Chawla Medical College and Hospital, Karnal for duration of 3 months (April-June 2020). The study was performed on the reported ADRs due to HCQ prophylaxis by the healthcare workers to the ADR monitoring centre of the institute during this period. Results: Gastrointestinal disturbance such as loose stool (16.4%) and hyperacidity (14.9%) were the most commonly reported ADRs during the study period. The incident rate of adverse drug reactions was 23.7%. The number of ADRs was found to be significantly (p<0.01) more in female as compared to male. We have observed that most of the reactions were reported following the 1st day loading dose. Conclusions: Our results showed that gastrointestinal system was most commonly affected. Loose stool and hyperacidity were most frequently reported ADRs due to HCQ prophylaxis. Larger studies are required to ensure the safety of the use of HCQ as prophylaxis for COVID 19.
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The outbreak of a novel coronavirus in Wuhan, China, in December 2019 led to a global crisis and a critical threat to the health of millions of people worldwide. Existing research indicates that besides typical respiratory symptoms and signs of COVID-19, gastrointestinal manifestations are also caused by coronavirus disease 2019 (COVID-19) and the main intention of this article is to compare the gastrointestinal disorders seen in patients infected by the virus as well as study the possible and logical mechanisms that may lead to these situations. The high rate of contagion of the virus and the number of current patients reveal the importance of this research and all other studies related to this subject.
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BACKGROUND: The impact of the coronavirus on hospitalizations for gastrointestinal (GI) disease, particularly at a population level is understudied. AIM: To investigate trends in hospitalizations, inpatient endoscopy resource utilization, and outcomes during the first year of the coronavirus pandemic and subsequent lockdowns. METHODS: Using the California State Inpatient Database for 2018-2020, we explored year-to-year and 2020 month-to-month trends in hospitalizations, length of stay, and inpatient mortality (all-cause & viral pneumonia-specific) for common inpatient GI diagnoses including acute pancreatitis, diverticulitis, cholelithiasis, non-infectious gastroenteritis, upper and lower GI bleeding (LGIB), Clostridium difficile, viral gastroenteritis, inflammatory bowel disease, and acute cholangitis. RESULTS: Disease-specific hospitalizations decreased for all included conditions except nonvariceal upper GI bleeding (NVUGIB), LGIB, and ulcerative colitis (UC) (ptrend < 0.0001). All-cause inpatient mortality was higher in 2020 vs 2019, for acute pancreatitis (P = 0.029), diverticulitis (P = 0.04), NVUGIB (P = 0.003), and Crohn's disease (P = 0.004). In 2020, hospitalization rates were lowest in April, November, and December. There was no significant corresponding increase in inpatient mortality except in UC (ptrend = 0.048). Viral pneumonia and viral pneumonia complicated by respiratory failure increased (P < 0.001) among GI hospitalizations. Endoscopy utilization within 24 h of admission was unchanged for GI emergencies except NVUGIB (P < 0.001). CONCLUSION: Our findings suggest that hospitalization rates for common GI conditions significantly declined in California during the COVID pandemic, particularly in April, November and December 2020. All-cause mortality was significantly higher among acute pancreatitis, diverticulitis, NVUGIB, and Crohn's disease hospitalizations. Emergency endoscopy rates were mostly comparable between 2020 and 2019.
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COVID-19 , Colitis, Ulcerative , Crohn Disease , Diverticulitis , Gastrointestinal Diseases , Pancreatitis , Humans , Crohn Disease/complications , Acute Disease , Pandemics , Pancreatitis/epidemiology , Pancreatitis/therapy , Pancreatitis/complications , COVID-19/epidemiology , COVID-19/therapy , COVID-19/complications , Communicable Disease Control , Hospitalization , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Gastrointestinal Diseases/complications , Gastrointestinal Hemorrhage/epidemiology , Gastrointestinal Hemorrhage/therapy , Gastrointestinal Hemorrhage/complications , Colitis, Ulcerative/complications , Diverticulitis/epidemiology , Retrospective StudiesABSTRACT
BACKGROUND: Gastrointestinal diseases are associated with substantial cost in health care. In times of the COVID-19 pandemic and further digitalization of gastrointestinal tract health care, mobile health apps could complement routine health care. Many gastrointestinal health care apps are already available in the app stores, but the quality, data protection, and reliability often remain unclear. OBJECTIVE: This systematic review aimed to evaluate the quality characteristics as well as the privacy and security measures of mobile health apps for the management of gastrointestinal diseases. METHODS: A web crawler systematically searched for mobile health apps with a focus on gastrointestinal diseases. The identified mobile health apps were evaluated using the Mobile Application Rating Scale (MARS). Furthermore, app characteristics, data protection, and security measures were collected. Classic user star rating was correlated with overall mobile health app quality. RESULTS: The overall quality of the mobile health apps (N=109) was moderate (mean 2.90, SD 0.52; on a scale ranging from 1 to 5). The quality of the subscales ranged from low (mean 1.89, SD 0.66) to good (mean 4.08, SD 0.57). The security of data transfer was ensured only by 11 (10.1%) mobile health apps. None of the mobile health apps had an evidence base. The user star rating did not correlate with the MARS overall score or with the individual subdimensions of the MARS (all P>.05). CONCLUSIONS: Mobile health apps might have a positive impact on diagnosis, therapy, and patient guidance in gastroenterology in the future. We conclude that, to date, data security and proof of efficacy are not yet given in currently available mobile health apps.
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COVID-19 , Gastrointestinal Diseases , Mobile Applications , Telemedicine , Gastrointestinal Diseases/therapy , Humans , Pandemics , Reproducibility of ResultsABSTRACT
Background: By the end of May 2021, 170 million cases and 3.54 million death from Covid-19 infection have been reported. The high affinity of virus particles to ACE-2 receptors in different body organs can cause varied clinical manifestations and complications. Ischemic colitis and necrosis are some rare complications of Covid-19 infection with high morbidity and mortality resulting from colonic hypoperfusion. Different underlying mechanisms for ischemic colitis in Covid-19 patients have been described, including hypercoagulable state, inflammatory responses, microthrombosis, and non-occlusive intestinal ischemia due to shock, hypoxemia, and low cardiac output. Case Presentation: here, we presented three patients with ischemic colitis and one rectal necrosis as a rare presentation of gastrointestinal complication of SARS-CoV-2 infection. All of our patients presented with abdominal pain and tenderness and received a standard regimen of antibiotics, anticoagulation, and ventilation support.
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Background: To the best of our knowledge, limited studies explored gastrointestinal (GI) symptoms and hepatopancreatic involvement in children with coronavirus disease 2019 (COVID-19) infection. Objectives: This review study aimed to evaluate the GI symptoms and abnormal liver and pancreas function in children with COVID-19 infection. Methods: In this review study, databases of Scopus, PubMed, Google Scholar, and Web of Science were searched using the relevant keywords of "COVID-19," "children," "gastrointestinal," "liver," and "pancreas." Descriptive and cross-sectional studies were reviewed in the current study, with the main focus on GI symptoms and elevated liver enzymes in children with COVID-19 infection. Results: Overall, 27 studies from countries of Iran, Spain, Turkey, Italy, and the United States were selected. Although the prevalence of GI symptoms varied in different studies, our review showed that most children with COVID-19 infection experienced GI symptoms. In addition to GI symptoms, there is the possibility of elevated liver enzymes, such as alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine phosphokinase in children with COVID-19 infection. Conclusions: COVID-19 infection may present various GI, hepatic, and pancreatic manifestations in children. The difference in the prevalence of these symptoms can probably be attributed to the geographical region of the study and the history of the disease.
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Persistence of a long-term positive polymerase chain reaction (PCR) test in patients with severe coronavirus-associated respiratory syndrome may interfere with the diagnosis of reinfections, causing false positives of the disease, with the potential implications to determine the need for isolation and, consequently, for Public Health. In these field notes we present the experience of a patient with positive PCR of eight months of evolution to which an erroneous diagnosis of COVID-19 reinfection was made due to a gastrointestinal disease, resulting in a Campylobacter jejuni infection.
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Pandemics obligate providers to transform their clinical practice. An extensive effort has been put to find out feasible approaches for gastrointestinal diseases and also to manage coronavirus disease 2019 (COVID-19) related gastrointestinal conditions. Diarrhea, hepatitis, and pancreatitis can be seen in the COVID-19 course. Endoscopic procedures increase the risk of contamination for medical staff and patients despite precautions, therefore indications should be tailored to balance risks vs benefits. Furthermore, whether the immunosupression in inflammatory bowel diseases, liver transplantation, and autoimmune liver diseases increases COVID-19 related risks and how to modify immunosupression are topics of ongoing debate. This review aims to provide most up to date practical approaches that a gastrointestinal fellow should be aware on the problems and management of gastrointestinal and hepatobiliary diseases during the COVID-19 pandemic.
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Campylobacteriosis is one of the most well-characterized bacterial foodborne infections worldwide, the species are the most common zoonotic pathogens. Chicken and chicken products are known to be the major sources of Campylobacter infection in humans. Campylobacter species represent one of the most common causes of bacterial diarrheal illness worldwide, it is the main cause of bacterial gastrointestinal infections occurring at any age, but it peaks in children and young adults. This study aims to investigate the presence and prevalence of Campylobacter bacteria in humans and chicken and aims for determination the extent of the contamination of this bacteria. The study involved two parts;the first part designed for isolation Campylobacter species from chickens which were alive, while the second part was about isolation Campylobacter species from human stool samples for different ages. The current study based on analysis of three hundred and fifty (350) stool samples taken from humans with different ages. The patients samples were collected from Al-Batool Teaching Hospital for Maternity and Pediatric, Baquba Teaching Hospital and Central Health Laboratories in Diyala, these patients were had vary clinical aspects like : (diarrhea, Fever, nausea, vomiting, abdominal pain and cramp, fatigue and muscle pain). On the other hand, one hundred seventy five (175) stool samples of chicken which they apparently had diarrhea were collected randomly from different areas of Diyala Governorate. The collection of both humans and chicken samples were during 2020 - 2021. The analysis of 350 samples of patients their ages ranged from 3 months to 59 years showed that the mean +or- SD of age was 24.5 +or- 14.3 years. The most predominant age group was 20-29 years (26.9%), while the lowest age group was 50-59 years (4.9%). Regarding the gender, 151 (43.1%) of the included patients were male and 199 (56.9%) were female. Patients included in the current study were collected from four districts of Diyala province. The highest collection rate was from Baquba district 217(62.0%), while the lowest collection rate was from Baladrooz district 18 (5.1%). the distribution of clinical signs and symptoms of included patients. Persistent diarrhea forming the predominance of signs 179 (51.1%), followed by watery diarrhea 55 (15.7%), while the least sign was vomiting 1(3%). Furthermore, 15 (4.3%) of patients showed all that signs and symptoms. The signs and symptoms were : diarrhea was found in 194 (55.4%) patients, followed by watery diarrhea in 77 (22.0%) patients. Fever was found in 30 (8.6%) patients. The least sign was nausea which was found in 15 (4.3%) patients. Abdominal pain and cramps were detected in 22 (6.3%) patients. Out of 350 stool specimens submitted for bacteriological culture, 62 (17.7%) were positive versus 288 (82.3%) were negative. Among the 62-culture positive, 13 specimens yield Campylobacter growth, so the campylobacter detection rate among human specimens was 3.7%. The isolated Campylobacter were as follow;11(3.1%) were Campylobacter jejuni, one (0.3%) was Campylobacter coli, one (0.3%) was undifferentiated campylobacter. On the other hand, 58 (16.6%) of the specimens yield bacterial growth other than Campylobacter, as follows: E. coli was detected in 28 (8.0%), Proteus Spp. was detected in 12 (3.4%), H. pylori was detected in 10 (2.9%) and Klebsiella Spp. was detected in 8 (2.3%). The remaining specimens 279 (79.7%) yield no growth. The results of the PCR technique revealed that 8 (2.38%) specimens were positive for Campylobacter, while the majority 335 (95.7%) were negative and 7(2.0%) of the specimens were not done. While the analysis of 175 chicken fecal samples taken from chickens were mainly suffering from diarrhea showed that the distribution of chickens according to their ages in days showed predominance was those 30-39 (40.6%) days old. It is clear that the majority of specimens (74.3%) were collected from Baquba districts. The results showed that specimens collected Al- Muqdadiya district farms had yielded the high
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This special issue includes 13 articles focusing on innate lymphoid cells and gastrointestinal disease;microbiota-gut-brain axis in autism spectrum disorder;characteristic dysbiosis in gout and the impact of a uric acid-lowering treatment, febuxostat on the gut microbiota;gut microbiota, inflammation, and molecular signatures of host response to infection;the rice histone methylation regulates hub species of the root microbiota;a powerful adaptive microbiome-based association test for microbial association signals with diverse sparsity levels;an efficient metatranscriptomic approach for capturing RNA virome and its application to SARS-CoV-2;easy to create repeatable and editable Venn diagrams and Venn networks online.
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OBJECTIVES: This study examined how trends in the weekly frequencies of gastrointestinal infectious diseases changed before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and compared them with the trends in the United States. METHODS: We compared the weekly frequencies of gastrointestinal infectious diseases (16 bacterial and 6 viral diseases) in Korea during weeks 5-52 before and after COVID-19. In addition, the weekly frequencies of 5 gastrointestinal infectious diseases in the United States (data from the Centers for Disease Control and Prevention) that overlapped with those in Korea were compared. RESULTS: The mean weekly number of total cases of gastrointestinal infectious diseases in Korea showed a significant decrease (from 522 before COVID-19 to 245 after COVID-19, p<0.01). Only bacterial gastrointestinal infectious diseases caused by Campylobacter increased significantly; other bacterial gastrointestinal infectious diseases showed either a decrease or no change. The incidence of all other viral diseases decreased. In the United States, the weekly numbers of Salmonella, Campylobacter, typhoid, shigellosis, and hepatitis A virus cases sharply decreased after the COVID-19 outbreak. The weekly case numbers of all viral diseases markedly decreased in both countries; however, bacterial gastrointestinal infectious diseases showed a different pattern. CONCLUSIONS: The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak. In contrast, Campylobacter infections showed an increasing trend in Korea, but a decreasing trend in the United States. Further studies are needed to elucidate the different trends in bacterial and viral infectious diseases before and after non-pharmaceutical interventions and between different countries.
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COVID-19 , Communicable Diseases , Virus Diseases , COVID-19/epidemiology , Communicable Diseases/epidemiology , Humans , Republic of Korea/epidemiology , SARS-CoV-2 , United States/epidemiologyABSTRACT
The public health interventions to mitigate coronavirus disease 2019 (COVID-19) could also potentially reduce the global activity of influenza. However, this strategy's impact on other common infectious diseases is unknown. We collected data of 10 respiratory infectious (RI) diseases, influenza-like illnesses (ILIs), and seven gastrointestinal infectious (GI) diseases during 2015-2020 in China and applied two proportional tests to check the differences in the yearly incidence and mortality, and case-fatality rates (CFRs) over the years 2015-2020. The results showed that the overall RI activity decreased by 7.47%, from 181.64 in 2015-2019 to 168.08 per 100 000 in 2020 (p < 0.001); however, the incidence of influenza was seen to have a 16.08% escalation (p < 0.001). In contrast, the average weekly ILI percentage and positive influenza virus rate decreased by 6.25% and 61.94%, respectively, in 2020 compared to the previous 5 years (all p < 0.001). The overall incidence of GI decreased by 45.28%, from 253.73 in 2015-2019 to 138.84 in 2020 per 100 000 (p < 0.001), and with the greatest decline seen in hand, foot, and mouth disease (HFMD) (64.66%; p < 0.001). The mortality and CFRs from RI increased by 128.49% and 146.95%, respectively, in 2020, compared to 2015-2019 (p < 0.001). However, the mortality rates and CFRs of seven GI decreased by 70.56% and 46.12%, respectively (p < 0.001). In conclusion, China's COVID-19 elimination/containment strategy is very effective in reducing the incidence rates of RI and GI, and ILI activity, as well as the mortality and CFRs of GI diseases.
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COVID-19 , Communicable Diseases , Influenza, Human , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Communicable Diseases/epidemiology , Humans , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Public Health , SARS-CoV-2ABSTRACT
Background and Aim: Overweight and obesity disrupt people's quality of life and increase the risk of cardiovascular diseases, diabetes, hypertension, gastrointestinal diseases and cancer. It also reduces the immunity of people against epidemic diseases. Materials and Methods: In this article, extensive search of electronic databases, review of national upstream documents as well as review of documents and reports of the Ministry of Health were conducted to comprehensively review the prevalence of obesity and its associated factors, measures taken to control this risk factor, and challenge of a syndemic of obesity and Covid-19 in Iran.
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BACKGROUND: In response to the COVID-19 pandemic, endoscopic societies initially recommended reduction of endoscopic procedures. In particular non-urgent endoscopies should be postponed. However, this might lead to unnecessary delay in diagnosing gastrointestinal conditions. METHODS: Retrospectively we analysed the gastrointestinal endoscopies performed at the Central Endoscopy Unit of Saarland University Medical Center during seven weeks from 23 March to 10 May 2020 and present our real-world single-centre experience with an individualized rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy. We also present our experience with this strategy in 2021. RESULTS: Altogether 359 gastrointestinal endoscopies were performed in the initial period. The testing strategy enabled us to conservatively handle endoscopy programme reduction (44% reduction as compared 2019) during the first wave of the COVID-19 pandemic. The results of COVID-19 rtPCR from nasopharyngeal swabs were available in 89% of patients prior to endoscopies. Apart from six patients with known COVID-19, all other tested patients were negative. The frequencies of endoscopic therapies and clinically significant findings did not differ between patients with or without SARS-CoV-2 tests. In 2021 we were able to unrestrictedly perform all requested endoscopic procedures (> 5000 procedures) by applying the rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy, regardless of next waves of COVID-19. Only two out-patients (1893 out-patient procedures) were tested positive in the year 2021. CONCLUSION: A structured pre-endoscopy SARS-CoV-2 testing strategy is feasible in the clinical routine of an endoscopy unit. rtPCR-based pre-endoscopy SARS-CoV-2 testing safely allowed unrestricted continuation of endoscopic procedures even in the presence of high incidence rates of COVID-19. Given the low frequency of positive tests, the absolute effect of pre-endoscopy testing on viral transmission may be low when FFP-2 masks are regularly used.