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1.
Curr Opin Gastroenterol ; 37(1): 23-29, 2021 01.
Article in English | MEDLINE | ID: covidwho-1031398

ABSTRACT

PURPOSE OF REVIEW: The COVID-19 pandemic has impacted the practicing gastroenterologist in several ways. Although majority of COVID-19 patients present with respiratory symptoms, gastrointestinal symptoms are also seen. COVID-19 has also disrupted gastrointestinal endoscopy services in numerous ways. There are also concerns regarding the impact of these changes on gastrointestinal cancer screening and management of chronic gastrointestinal diseases. The purpose of this review is to provide an overview of the implications of COVID-19 for the practicing gastroenterologist. RECENT FINDINGS: COVID-19 patients can have gastrointestinal symptoms including diarrhea, nausea and vomiting, abdominal pain and anorexia. Separate from the management of COVID-19 patients, there has been a reduction in endoscopy volume worldwide. This has also resulted in reduction/cessation of in-person clinic visits and an increasing use of telemedicine services. In addition, patients with certain chronic diseases like chronic liver disease or inflammatory bowel disease may have worse outcomes during the COVID-19 pandemic. SUMMARY: Gastroenterologists need to rapidly adapt to the challenges being faced and need to make both systems and practice-based changes to the endoscopy unit and outpatient clinic practices. Gastroenterologists should stay up-to-date with the rapidly evolving literature regarding gastrointestinal symptoms in COVID-19 patients as well as its impact on chronic gastrointestinal illnesses.


Subject(s)
Gastroenterology/methods , Gastrointestinal Diseases , /complications , /therapy , Chronic Disease , Endoscopy, Gastrointestinal/methods , Gastroenterology/organization & administration , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/therapy , Gastrointestinal Diseases/virology , Global Health , Health Care Rationing/methods , Health Services Accessibility , Humans , Infection Control/methods , Practice Patterns, Physicians' , Telemedicine/methods
2.
J Crohns Colitis ; 14(Supplement_3): S780-S784, 2020 Oct 21.
Article in English | MEDLINE | ID: covidwho-883092

ABSTRACT

Before the onset of the COVID-19 pandemic, the majority of care for inflammatory bowel disease patients was provided in-person. The practice of gastroenterology care has since rapidly transformed, with telemedicine emerging as an essential tool to provide medical care to patients while maintaining social distancing and conserving personal protective equipment. This article provides insight into past and current practices among inflammatory bowel disease specialists and shares regulatory, financial and practical considerations for incorporating telemedicine into clinical practice. Continued government and other payer support for telemedicine and ongoing innovation to provide remote objective patient data will help to sustain the use of telemedicine long after the current pandemic subsides.


Subject(s)
Betacoronavirus , Coronavirus Infections/prevention & control , Gastroenterology/methods , Inflammatory Bowel Diseases/therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Patterns, Physicians'/trends , Telemedicine/methods , Gastroenterology/organization & administration , Gastroenterology/trends , Global Health , Humans , Inflammatory Bowel Diseases/complications , Practice Patterns, Physicians'/standards , Telemedicine/organization & administration , Telemedicine/trends
3.
PLoS One ; 15(10): e0240397, 2020.
Article in English | MEDLINE | ID: covidwho-841010

ABSTRACT

BACKGROUND: There is a need to understand the impact of COVID-19 on colorectal cancer care globally and determine drivers of variation. OBJECTIVE: To evaluate COVID-19 impact on colorectal cancer services globally and identify predictors for behaviour change. DESIGN: An online survey of colorectal cancer service change globally in May and June 2020. PARTICIPANTS: Attending or consultant surgeons involved in the care of patients with colorectal cancer. MAIN OUTCOME MEASURES: Changes in the delivery of diagnostics (diagnostic endoscopy), imaging for staging, therapeutics and surgical technique in the management of colorectal cancer. Predictors of change included increased hospital bed stress, critical care bed stress, mortality and world region. RESULTS: 191 responses were included from surgeons in 159 centers across 46 countries, demonstrating widespread service reduction with global variation. Diagnostic endoscopy was reduced in 93% of responses, even with low hospital stress and mortality; whilst rising critical care bed stress triggered complete cessation (p = 0.02). Availability of CT and MRI fell by 40-41%, with MRI significantly reduced with high hospital stress. Neoadjuvant therapy use in rectal cancer changed in 48% of responses, where centers which had ceased surgery increased its use (62 vs 30%, p = 0.04) as did those with extended delays to surgery (p<0.001). High hospital and critical care bed stresses were associated with surgeons forming more stomas (p<0.04), using more experienced operators (p<0.003) and decreased laparoscopy use (critical care bed stress only, p<0.001). Patients were also more actively prioritized for resection, with increased importance of co-morbidities and ICU need. CONCLUSIONS: The COVID-19 pandemic was associated with severe restrictions in the availability of colorectal cancer services on a global scale, with significant variation in behaviours which cannot be fully accounted for by hospital burden or mortality.


Subject(s)
Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/therapy , Coronavirus Infections/epidemiology , Elective Surgical Procedures , Health Care Rationing , Pneumonia, Viral/epidemiology , Betacoronavirus/physiology , Elective Surgical Procedures/statistics & numerical data , Female , Gastroenterology/organization & administration , Gastroenterology/statistics & numerical data , Health Services Needs and Demand , Humans , Male , Pandemics , Patient Safety
4.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(5): 501-506, 2020 May 28.
Article in English, Chinese | MEDLINE | ID: covidwho-745316

ABSTRACT

OBJECTIVES: To establish a system for control of cross-infection and workflow for preventing severe acute respiratory syndrome coronavirus 2 spread and ensuring the safety of medical staffs and patients in endoscopy center during the pandemic of the coronavirus disease 2019 (COVID-19). METHODS: Based on the national publication of relevant documents and relevant guidance of Digestive Endoscopy Branch of Chinese Medical Association, we explored and optimized the workflow, staff protection and sterilization of endoscope in digestive endoscopy center during the pandemic of the COVID-19. RESULTS: The prevention system of cross-infection and workflow in endoscopy during the pandemic of the COVID-19 were developed. The optimized workflow in endoscopy was conducted in 106 patients with necessary endoscopy from the Department of Gastroenterology, Third Xiangya Hospital, Central South University between January 24, 2020 and February 26, 2020, and no case of cross-infection was presented among the medical staffs, patients and family members. CONCLUSIONS: Measures on control of cross-infection and workflow in digestive endoscopy center during the pandemic of the COVID-19 are effective, which are beneficial to preventing cross-infection in hospital and provide a scientific guidance for the general work in the digestive endoscopy centers during the pandemic of the COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Cross Infection/prevention & control , Endoscopy , Gastroenterology/organization & administration , Pneumonia, Viral/epidemiology , Workflow , Betacoronavirus , China , Coronavirus Infections/prevention & control , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control
5.
Gastroenterol Hepatol ; 43(8): 472-480, 2020 Oct.
Article in English, Spanish | MEDLINE | ID: covidwho-707319

ABSTRACT

The SARS-CoV-2 pandemic has proven to be a serious challenge for the Spanish healthcare system. The impact of the virus on the liver is not well known, but in patients with chronic liver disease, mostly in advanced stages, it can critically compromise survival and trigger decompensation. Treatment in this subpopulation is complex due to the potential hepatotoxicity of some of the medicinal products used. Moreover, the pandemic has also negatively impacted patients with liver disease who have not contracted COVID-19, since the reallocation of human and material resources to the care of patients with the virus has resulted in a decrease in the treatment, diagnosis and follow-up of patients with liver disease, which will surely have negative consequences in the near future. Efficient reorganization of hepatology units is a priority to minimise the impact of the pandemic on a population as vulnerable as liver disease patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Liver Diseases/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Age Factors , Alanine/adverse effects , Alanine/analogs & derivatives , Alanine/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Bile Ducts/virology , Chemical and Drug Induced Liver Injury/etiology , Chronic Disease , Comorbidity , Coronavirus Infections/drug therapy , Disease Susceptibility , Gastroenterology/organization & administration , Health Resources/supply & distribution , Hepatitis, Chronic/drug therapy , Hepatitis, Chronic/epidemiology , Humans , Immunosuppressive Agents/adverse effects , Liver/drug effects , Liver/pathology , Liver/virology , Liver Function Tests , Liver Transplantation , Obesity/epidemiology , Resource Allocation , Risk Factors
6.
Gastroenterol Hepatol ; 43(6): 332-347, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-658769

ABSTRACT

The set of measures proposed by SEPD, AEEH, GETECCU and AEG are aimed to help departments in their resumption of usual activity. We have prepared a number of practical recommendations regarding patient management and the stepwise resumption of healthcare activity. These recommendations are based on the sparse, changing evidence available, and will be updated in the future according to daily needs and the availability of expendable materials to suit them; in each department they will be implemented depending upon the cumulative incidence of SARS-CoV-2 infection in each region, and the burden the pandemic has represented for each hospital. The general objectives of these recommendations include: (a)To protect our patients against the risks of infection with SARS-CoV-2 and to provide them with high-quality care. (b)To protect all healthcare professionals against the risks of infection with SARS-CoV-2. (c)To resume normal functioning of our departments in a setting of ongoing risk for infection with SARS-CoV-2.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/organization & administration , Hospital Departments/organization & administration , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Appointments and Schedules , Clinical Laboratory Techniques , Clinical Trials as Topic , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Cross Infection/prevention & control , Diagnostic Techniques, Digestive System/instrumentation , Digestive System Diseases/complications , Digestive System Diseases/diagnosis , Digestive System Diseases/therapy , Disinfection , Drug Interactions , Equipment Contamination/prevention & control , Home Care Services/organization & administration , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Liver Transplantation , Mass Screening/organization & administration , Occupational Diseases/prevention & control , Pneumonia, Viral/drug therapy , Pneumonia, Viral/transmission , Protective Devices , Symptom Assessment , Telemedicine/organization & administration , Universal Precautions
7.
Intern Med J ; 50(7): 798-804, 2020 07.
Article in English | MEDLINE | ID: covidwho-639949

ABSTRACT

The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has emerged as a public health emergency and challenged healthcare systems globally. In a minority of patients, SARS-CoV-2 manifests with a severe acute respiratory illness and currently there is insufficient data regarding the virulence of COVID-19 in inflammatory bowel disease patients taking immunosuppressive therapy. This review aims to summarise the current literature and provide guidance on the management of inflammatory bowel disease patients in the context of the COVID-19 pandemic in the Australasian setting.


Subject(s)
Coronavirus Infections , Gastroenterology , Immunologic Factors/pharmacology , Inflammatory Bowel Diseases , Pandemics , Patient Care Management , Pneumonia, Viral , Australia , Betacoronavirus/isolation & purification , Change Management , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Disease Management , Gastroenterology/organization & administration , Gastroenterology/trends , Humans , Inflammatory Bowel Diseases/epidemiology , Inflammatory Bowel Diseases/immunology , Inflammatory Bowel Diseases/therapy , Pandemics/prevention & control , Patient Care Management/methods , Patient Care Management/trends , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Risk Management
8.
Scand J Gastroenterol ; 55(8): 1005-1011, 2020 08.
Article in English | MEDLINE | ID: covidwho-638746

ABSTRACT

While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. We review the data and understanding around the virus related to the digestive tract, impact of the pandemic on delivery of GI services and daily gastroenterology clinical practice, and the effects on patients with pre-existing GI diseases.


Subject(s)
Coronavirus Infections/epidemiology , Gastroenterology/organization & administration , Health Services Accessibility/statistics & numerical data , Infection Control/organization & administration , Pandemics/statistics & numerical data , Patient Care Team/organization & administration , Pneumonia, Viral/epidemiology , Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Female , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Health Personnel/organization & administration , Humans , Male , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , United States
9.
Gut ; 69(9): 1555-1563, 2020 09.
Article in English | MEDLINE | ID: covidwho-634628

ABSTRACT

The COVID-19 pandemic has led to an exponential increase in SARS-CoV-2 infections and associated deaths, and represents a significant challenge to healthcare professionals and facilities. Individual countries have taken several prevention and containment actions to control the spread of infection, including measures to guarantee safety of both healthcare professionals and patients who are at increased risk of infection from COVID-19. Faecal microbiota transplantation (FMT) has a well-established role in the treatment of Clostridioides difficile infection. In the time of the pandemic, FMT centres and stool banks are required to adopt a workflow that continues to ensure reliable patient access to FMT while maintaining safety and quality of procedures. In this position paper, based on the best available evidence, worldwide FMT experts provide guidance on issues relating to the impact of COVID-19 on FMT, including patient selection, donor recruitment and selection, stool manufacturing, FMT procedures, patient follow-up and research activities.


Subject(s)
Clostridium Infections/therapy , Coronavirus Infections , Donor Selection , Fecal Microbiota Transplantation/methods , Gastroenterology , Pandemics , Patient Selection , Pneumonia, Viral , Betacoronavirus , Change Management , Clostridium Infections/microbiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Gastroenterology/organization & administration , Gastroenterology/trends , Gastrointestinal Microbiome , Humans , Infection Control/methods , Infection Control/standards , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Risk Adjustment/methods , Risk Adjustment/standards
10.
Gastroenterol Hepatol ; 43(8): 472-480, 2020 Oct.
Article in English, Spanish | MEDLINE | ID: covidwho-621606

ABSTRACT

The SARS-CoV-2 pandemic has proven to be a serious challenge for the Spanish healthcare system. The impact of the virus on the liver is not well known, but in patients with chronic liver disease, mostly in advanced stages, it can critically compromise survival and trigger decompensation. Treatment in this subpopulation is complex due to the potential hepatotoxicity of some of the medicinal products used. Moreover, the pandemic has also negatively impacted patients with liver disease who have not contracted COVID-19, since the reallocation of human and material resources to the care of patients with the virus has resulted in a decrease in the treatment, diagnosis and follow-up of patients with liver disease, which will surely have negative consequences in the near future. Efficient reorganization of hepatology units is a priority to minimise the impact of the pandemic on a population as vulnerable as liver disease patients.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Liver Diseases/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Adenosine Monophosphate/adverse effects , Adenosine Monophosphate/analogs & derivatives , Adenosine Monophosphate/therapeutic use , Age Factors , Alanine/adverse effects , Alanine/analogs & derivatives , Alanine/therapeutic use , Antiviral Agents/adverse effects , Antiviral Agents/therapeutic use , Bile Ducts/virology , Chemical and Drug Induced Liver Injury/etiology , Chronic Disease , Comorbidity , Coronavirus Infections/drug therapy , Disease Susceptibility , Gastroenterology/organization & administration , Health Resources/supply & distribution , Hepatitis, Chronic/drug therapy , Hepatitis, Chronic/epidemiology , Humans , Immunosuppressive Agents/adverse effects , Liver/drug effects , Liver/pathology , Liver/virology , Liver Function Tests , Liver Transplantation , Obesity/epidemiology , Resource Allocation , Risk Factors
12.
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 , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission
15.
Dig Liver Dis ; 52(10): 1178-1187, 2020 10.
Article in English | MEDLINE | ID: covidwho-276933

ABSTRACT

The pandemic diffusion of the SARS-CoV-2 infection throughout the world required measures to prevent and strategies to control the infection, as well as the reallocation of the hospital structures in order to take care of an increased number of infected patients. Endoscopy Units should be able to perform endoscopic procedures on COVID-19 infected as well as on noninfected patients. The aim of this manuscript is to propose a model for a fast reorganization of the endoscopy department environment in order to safely perform endoscopic procedures in this Pandemic COVID-19 scenario, according to the current advices given by the Scientific Societies.


Subject(s)
Coronavirus Infections , Endoscopy, Digestive System/methods , Environment Design , Gastroenterology/organization & administration , Hospital Units/organization & administration , Infection Control/methods , Pandemics , Pneumonia, Viral , Betacoronavirus , Humans , Personal Protective Equipment
16.
Gastroenterol Hepatol ; 43(6): 332-347, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-116776

ABSTRACT

The set of measures proposed by SEPD, AEEH, GETECCU and AEG are aimed to help departments in their resumption of usual activity. We have prepared a number of practical recommendations regarding patient management and the stepwise resumption of healthcare activity. These recommendations are based on the sparse, changing evidence available, and will be updated in the future according to daily needs and the availability of expendable materials to suit them; in each department they will be implemented depending upon the cumulative incidence of SARS-CoV-2 infection in each region, and the burden the pandemic has represented for each hospital. The general objectives of these recommendations include: (a)To protect our patients against the risks of infection with SARS-CoV-2 and to provide them with high-quality care. (b)To protect all healthcare professionals against the risks of infection with SARS-CoV-2. (c)To resume normal functioning of our departments in a setting of ongoing risk for infection with SARS-CoV-2.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/organization & administration , Hospital Departments/organization & administration , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Appointments and Schedules , Clinical Laboratory Techniques , Clinical Trials as Topic , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Cross Infection/prevention & control , Diagnostic Techniques, Digestive System/instrumentation , Digestive System Diseases/complications , Digestive System Diseases/diagnosis , Digestive System Diseases/therapy , Disinfection , Drug Interactions , Equipment Contamination/prevention & control , Home Care Services/organization & administration , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Liver Transplantation , Mass Screening/organization & administration , Occupational Diseases/prevention & control , Pneumonia, Viral/drug therapy , Pneumonia, Viral/transmission , Protective Devices , Symptom Assessment , Telemedicine/organization & administration , Universal Precautions
17.
Clin Gastroenterol Hepatol ; 18(8): 1673-1681, 2020 07.
Article in English | MEDLINE | ID: covidwho-102150

ABSTRACT

The COVID-19 pandemic seemingly is peaking now in New York City and has triggered significant changes to the standard management of gastrointestinal diseases. Priorities such as minimizing viral transmission, preserving personal protective equipment, and freeing hospital beds have driven unconventional approaches to managing gastroenterology (GI) patients. Conversion of endoscopy units to COVID units and redeployment of GI fellows and faculty has profoundly changed the profile of most GI services. Meanwhile, consult and procedural volumes have been reduced drastically. In this review, we share our collective experiences regarding how we have changed our practice of medicine in response to the COVID surge. Although we review our management of specific consults and conditions, the overarching theme focuses primarily on noninvasive measures and maximizing medical therapies. Endoscopic procedures have been reserved for those timely interventions that are most likely to be therapeutic. The role of multidisciplinary discussion, although always important, now has become critical. The support of our faculty and trainees remains essential. Local leadership can encourage well-being by frequent team check-ins and by fostering trainee development through remote learning. Advancing a clear vision and a transparent process for how to organize and triage care in the recovery phase will allow for a smooth transition to our new normal.


Subject(s)
Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Disease Management , Disease Transmission, Infectious/prevention & control , Gastroenterology/methods , Gastroenterology/organization & administration , Infection Control/methods , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Humans , New York City/epidemiology , Pandemics
19.
Gastroenterology ; 159(1): 350-357, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-46654

ABSTRACT

The purpose of this American Gastroenterological Association (AGA) Institute Clinical Practice Update was to rapidly review the emerging evidence and provide timely expert recommendations regarding the management of patients with inflammatory bowel disease during the coronavirus disease 2019 pandemic. This expert commentary was commissioned and approved by the AGA Institute Clinical Practice Updates Committee and the AGA Governing Board to provide timely perspective on a topic of high clinical importance to the AGA membership, and underwent internal peer review by the Clinical Practice Updates Committee and external peer review through standard procedures of Gastroenterology.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/prevention & control , Gastroenterology/standards , Inflammatory Bowel Diseases/drug therapy , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Practice Guidelines as Topic , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/adverse effects , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/immunology , Gastroenterology/organization & administration , Humans , Infection Control/organization & administration , Infection Control/standards , Inflammatory Bowel Diseases/diagnosis , Inflammatory Bowel Diseases/immunology , Infusions, Intravenous/standards , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/immunology , Risk Assessment/standards , Risk Factors , Severity of Illness Index , Societies, Medical/standards , United States
20.
United European Gastroenterol J ; 8(5): 520-527, 2020 06.
Article in English | MEDLINE | ID: covidwho-46637

ABSTRACT

A new strain of coronavirus, called SARS-CoV-2, emerged in Wuhan, China, in December 2019, probably originating from a wild-animal contamination. Since then, the situation rapidly evolved from a cluster of patients with pneumonia, to a regional epidemic and now to a pandemic called COrona VIrus Disease 2019 (COVID-19). This evolution is related to the peculiar modes of transmission of the disease and to the globalization and lifestyle of the 21st century that created the perfect scenario for virus spread. Even though research has not evidenced particular susceptibility of inflammatory bowel disease (IBD) patients to SARS-CoV-2 infection, immunosuppressive and immunomodulatory treatments were considered potential risk factors. In this context, initiating treatments with these agents should be cautiously weighted and regular ongoing treatments shall be continued, while the dose of corticosteroids should be reduced whenever possible. Due to the increased risk of contamination, elective endoscopic procedures and surgeries should be postponed and IBD online appointments shall be considered. IBD patients shall also follow the recommendations provided to the general population, such as minimization of contact with infected or suspected patients and to wash hands frequently. In the absence of effective treatments and vaccines, this pandemic can only be controlled through prevention of SARS-CoV-2 transmission with the main objectives of providing patients the best healthcare possible and reduce mortality.


Subject(s)
Betacoronavirus , Coronavirus Infections/transmission , Immunocompromised Host , Inflammatory Bowel Diseases/immunology , Pandemics , Pneumonia, Viral/transmission , Coronavirus Infections/drug therapy , Coronavirus Infections/prevention & control , Disinfection , Endoscopy/instrumentation , Equipment Contamination/prevention & control , Gastroenterology/organization & administration , Global Health , Hospital Departments/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/drug therapy , Pneumonia, Viral/prevention & control , Risk Factors , Travel
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