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1.
Lancet Gastroenterol Hepatol ; 7(5): 485-494, 2022 05.
Article in English | MEDLINE | ID: covidwho-1783874

ABSTRACT

GASTROSWOT is a strategic analysis of the current and projected states of the different subspecialties in gastroenterology that aims to provide guidance for research, clinical, and financial planning in gastroenterology. We executed a consensus-based international strengths, weaknesses, opportunities, and threats (SWOT) analysis. Four general coordinators, six field coordinators, and 12 experts participated in the study. SWOTs were provided for the following fields: neurogastroenterology, functional gastrointestinal disorders, and upper gastrointestinal diseases; inflammatory bowel disease; pancreatology and biliary diseases; endoscopy; gastrointestinal oncology; and hepatology. The GASTROSWOT analysis highlights the following in the current state of the field of gastroenterology: the incidence and complexity of several gastrointestinal diseases, including malignancies, are increasing; the COVID-19 pandemic has affected patient care on several levels; and with the advent of technical innovations in gastroenterology, a well trained workforce and strategic planning are required to optimise health-care utilisation. The analysis calls attention to the following in the future of gastroenterology: artificial intelligence and the use of big data will speed up discovery and smarter health-care provision in the field; the growth and diversification of gastroenterological specialties will improve specialised care for patients, but could promote fragmentation of care and health system inefficiencies; and furthermore, thoughtful planning is needed to reach an effective balance between the need for subspecialists and the value of general gastroenterology services.


Subject(s)
COVID-19 , Gastroenterology , Gastrointestinal Diseases , Artificial Intelligence , Endoscopy, Gastrointestinal , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/therapy , Humans , Pandemics
3.
World J Pediatr ; 18(2): 83-90, 2022 02.
Article in English | MEDLINE | ID: covidwho-1603411

ABSTRACT

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that develops from and is linked to coronavirus disease 2019. MIS-C is considered a multi-organ dysfunction involving cardiac, renal, respiratory, hematologic, gastrointestinal and neurological symptoms and groups of signs and symptoms such as rash or bilateral non-purulent conjunctivitis, hypotension or shock and acute gastrointestinal problems, which require immediate therapeutic intervention to prevent the aggravation of the patient's health condition. MIS-C is relatively new in the field of evidence-based medicine; however, there are several clinical guidelines for good clinical practice. For every disorder, the guidelines have different suggestions. Hence, based on the current status of the evidence, recommendations have been combined to form a unified guideline for therapeutic management. METHODS: This paper compares and evaluates the current MIS-C-specific clinical practice guidelines (namely, American Academy of Pediatrics, American College of Rheumatology, Helen DeVos Children's Hospital Foundation, Children's Hospital of The King's Daughters, and the Infectious Diseases Society of America). The compiled literature was then assessed by the authors separately, and an algorithm was proposed for each disorder, taking into consideration the various guidelines proposed for the management of the disorder. RESULTS: The features of MIS-C patients are unified; this is very helpful in managing its symptoms and decreasing mortality rates. In addition, recommendations for pharmacological treatment for MIS-C symptoms are formulated after cross-comparison across five different guidelines. CONCLUSIONS: This study provides a general interpretation of the results in the context of other evidence and implications for future research. It proposes a unified guideline based on the current evidence, with the best potential to maintain suitable clinical standards in the Saudi Arabian Ministry of Health.


Subject(s)
COVID-19 , Systemic Inflammatory Response Syndrome/therapy , COVID-19/complications , Child , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/therapy , Humans , Practice Guidelines as Topic , SARS-CoV-2 , Saudi Arabia , Systemic Inflammatory Response Syndrome/etiology
4.
Pediatr Ann ; 50(8): e315-e319, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1456367

ABSTRACT

Since its initial onset in 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread quickly across the globe, resulting in the potentially life-threatening respiratory coronavirus disease 2019 (COVID-19). Although less commonly reported, COVID-19 has also been associated with gastrointestinal and hepatic manifestations, which may occur more frequently in children. This has also led to concern about the susceptibility of children to the SARS-CoV-2 virus who have underlying chronic digestive disease and may be treated with immune suppression. As such, recommendations and expert consensus regarding the management of chronic gastrointestinal and hepatobiliary disease have been of great interest during the pandemic and international database reporting has informed our understanding. The impact of COVID-19 on the gastrointestinal tract and its influence on the management of pediatric digestive disease is reviewed in this article. [Pediatr Ann. 2021;50(8):e315-e319.].


Subject(s)
COVID-19 , Digestive System Diseases , Gastrointestinal Diseases , Child , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/therapy , Gastrointestinal Tract/pathology , Humans , Pandemics , SARS-CoV-2
5.
Inflamm Bowel Dis ; 28(2): e21, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1369087

ABSTRACT

This letter elucidates the potential novel therapeutic value of electroacupuncture in coronavirus disease 2019 (COVID-19) patients. As a classic treatment of traditional Chinese medicine, electroacupuncture has outstanding effects in the conditioning of gastrointestinal functions for COVID-19 gastrointestinal symptoms.


Subject(s)
COVID-19 , Electroacupuncture , Gastrointestinal Diseases , Gastrointestinal Diseases/therapy , Humans , SARS-CoV-2
6.
Am J Chin Med ; 49(2): 237-268, 2021.
Article in English | MEDLINE | ID: covidwho-1365230

ABSTRACT

Intestinal flora is essential for maintaining host health and plays a unique role in transforming Traditional Chinese Medicine (TCM). TCM, as a bodyguard, has saved countless lives and maintained human health in the long history, especially in this COVID-19 pandemic. Pains of diseases have been removed from the effective TCM therapy, such as TCM preparation, moxibustion, and acupuncture. With the development of life science and technology, the wisdom and foresight of TCM has been more displayed. Furthermore, TCM has been also inherited and developed in innovation to better realize the modernization and globalization. Nowadays, intestinal flora transforming TCM and TCM targeted intestinal flora treating diseases have been important findings in life science. More and more TCM researches showed the significance of intestinal flora. Intestinal flora is also a way to study TCM to elucidate the profound theory of TCM. Processing, compatibility, and properties of TCM are well demonstrated by intestinal flora. Thus, it is no doubt that intestinal flora is a core in TCM study. The interaction between intestinal flora and TCM is so crucial for host health. Therefore, it is necessary to sum up the latest results in time. This paper systematically depicted the profile of TCM and the importance of intestinal flora in host. What is more, we comprehensively summarized and discussed the latest progress of the interplay between TCM and intestinal flora to better reveal the core connotation of TCM.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Dysbiosis/microbiology , Gastrointestinal Microbiome , Medicine, Chinese Traditional , Autoimmune Diseases/microbiology , Autoimmune Diseases/therapy , COVID-19 , Cardiovascular Diseases/microbiology , Cardiovascular Diseases/therapy , Diabetes Mellitus/microbiology , Diabetes Mellitus/therapy , Electroacupuncture , Gastrointestinal Diseases/microbiology , Gastrointestinal Diseases/therapy , Humans , Metabolic Diseases/microbiology , Metabolic Diseases/therapy , Neoplasms/microbiology , Neoplasms/therapy , Non-alcoholic Fatty Liver Disease/microbiology , Non-alcoholic Fatty Liver Disease/therapy , Obesity/microbiology , Obesity/therapy , Renal Insufficiency, Chronic/microbiology , Renal Insufficiency, Chronic/therapy , SARS-CoV-2
8.
World J Gastroenterol ; 27(28): 4504-4535, 2021 Jul 28.
Article in English | MEDLINE | ID: covidwho-1335269

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered the causative pathogen of coronavirus disease 2019 (COVID-19) and has become an international danger to human health. Although respiratory transmission and symptoms are still the essential manifestations of COVID-19, the digestive system could be an unconventional or supplementary route for COVID-19 to be transmitted and manifested, most likely due to the presence of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract. In addition, SARS-CoV-2 can trigger hepatic injury via direct binding to the ACE2 receptor in cholangiocytes, antibody-dependent enhancement of infection, systemic inflammatory response syndrome, inflammatory cytokine storms, ischemia/reperfusion injury, and adverse events of treatment drugs. Gastrointestinal symptoms, including anorexia, nausea, vomiting, and diarrhea, which are unusual in patients with COVID-19, and some digestive signs may occur without other respiratory symptoms. Furthermore, SARS-CoV-2 can be found in infected patients' stool, demonstrating the likelihood of transmission through the fecal-oral route. In addition, liver function should be monitored during COVID-19, particularly in more severe cases. This review summarizes the evidence for extra-pulmonary manifestations, mechanisms, and management of COVID-19, particularly those related to the gastrointestinal tract and liver.


Subject(s)
COVID-19 , Gastrointestinal Diseases , Liver Diseases , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Gastrointestinal Tract , Humans , Liver Diseases/epidemiology , Liver Diseases/therapy , Pandemics , SARS-CoV-2
10.
Dtsch Med Wochenschr ; 146(13-14): 891-893, 2021 Jul.
Article in German | MEDLINE | ID: covidwho-1307352

ABSTRACT

During COVID 19 pandemic patients typically present with respiratory symptoms. However, in a significant number of patients the gastrointestinal tract is also involved in the disease. Up to 20 % of patients suffering from gastrointestinal symptoms. New insights in pathophysiological aspects might open new therapeutic concepts. This up-date includes current data regarding epidemiology of gastrointestinal symptoms in COVID 19, its role for prognosis and specific risks in relation to immunosuppressive therapies and underlying diseases.


Subject(s)
COVID-19/complications , Gastrointestinal Diseases/etiology , Liver Diseases/virology , Pancreatic Diseases/virology , SARS-CoV-2/physiology , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Humans , Prevalence , Prognosis , Risk Factors , SARS-CoV-2/pathogenicity
11.
World J Gastroenterol ; 27(23): 3303-3316, 2021 Jun 21.
Article in English | MEDLINE | ID: covidwho-1282666

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), is responsible for the first pandemic of the 21st century. As found in adults, signs and symptoms related to the disease mainly involve the respiratory tract in the paediatric population. However, a considerable number of children present with gastrointestinal symptoms such as vomiting, abdominal pain, and diarrhea. The purpose of this review is an accurate description, from pathogenesis to clinical presentation, diagnosis and treatment, of COVID-19 effects on the gastrointestinal system at a paediatric age. SARS-CoV-2 can be identified in stool specimens of affected children by real-time polymerase chain reaction techniques. Positivity can last for several weeks after the end of the symptomatic phase. Gastrointestinal signs and symptoms are generally self-limited, can correlate with blood tests and imaging alterations, and may require supportive treatment such as hydration. However, they can precede severe disease manifestations such as the COVID-19-related multisystem inflammatory syndrome. Children belonging to risk categories such as those affected by celiac disease, inflammatory bowel disease, and hepatic disease seem to not have a more severe course than the others, even if they are undergoing immunosuppressant treatment. Medical follow-ups of patients with chronic diseases need to be revised during the pandemic period in order to postpone unnecessary tests, mainly endoscopic ones.


Subject(s)
COVID-19 , Gastrointestinal Diseases , Adult , Child , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Gastrointestinal Tract , Humans , Pandemics , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
12.
Clin Transl Gastroenterol ; 12(6): e00365, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1249736

ABSTRACT

INTRODUCTION: The initial surge of the coronavirus disease 2019 (COVID-19) pandemic prompted national recommendations to delay nonurgent endoscopic procedures. The objective of this study was to provide real-world data on the impact of COVID-19 on endoscopic procedures in a safety-net healthcare system and cancer center affiliated with a tertiary academic center. METHODS: This retrospective cohort study used a combination of electronic health record data and a prospective data tool created to track endoscopy procedures throughout COVID-19 to describe patient and procedural characteristics of endoscopic procedures delayed during the initial COVID-19 surge. RESULTS: Of the 480 patients identified, the median age was 57 years (interquartile range 46-66), 55% (n = 262) were male, and 59% self-identified as white. Colonoscopy was the most common type of delayed procedure (49%), followed by combined esophagogastroduodenoscopy (EGD) and colonoscopy (22%), and EGD alone (20%). Colorectal cancer screening was the most common indication for delayed colonoscopy (35%), and evaluation of suspected bleeding (30%) was the most common indication for delayed combined EGD and colonoscopy. To date, 46% (223/480) of delayed cases have been completed with 12 colorectal, pancreatic, and stomach cancers diagnosed. Sociodemographic factors, procedure type, and sedation type were not significantly associated with endoscopy completion. The median time to endoscopy after delayed procedure was 88 days (interquartile range 63-119) with no differences by procedure type. DISCUSSION: To minimize potential losses to follow-up, delayed, or missed diagnoses and to reduce progression of gastrointestinal diseases, all efforts should be used to ensure follow-up in those whose endoscopic procedures were delayed because of COVID-19.


Subject(s)
COVID-19/epidemiology , Delayed Diagnosis , Endoscopy, Gastrointestinal/statistics & numerical data , Gastrointestinal Diseases/diagnosis , Pandemics , Aged , Female , Gastrointestinal Diseases/therapy , Humans , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Time-to-Treatment , Washington/epidemiology
13.
Lancet Gastroenterol Hepatol ; 6(5): 381-390, 2021 05.
Article in English | MEDLINE | ID: covidwho-1202043

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to a substantial reduction in gastrointestinal endoscopies, creating a backlog of procedures. We aimed to quantify this backlog nationally for England and assess how various interventions might mitigate the backlog. METHODS: We did a national analysis of data for colonoscopies, flexible sigmoidoscopies, and gastroscopies from National Health Service (NHS) trusts in NHS England's Monthly Diagnostic Waiting Times and Activity dataset. Trusts were excluded if monthly data were incomplete. To estimate the potential backlog, we used linear logistic regression to project the cumulative deficit between actual procedures performed and expected procedures, based on historical pre-pandemic trends. We then made further estimations of the change to the backlog under three scenarios: recovery to a set level of capacity, ranging from 90% to 130%; further disruption to activity (eg, second pandemic wave); or introduction of faecal immunochemical testing (FIT) triaging. FINDINGS: We included data from Jan 1, 2018, to Oct 31, 2020, from 125 NHS trusts. 10 476 endoscopy procedures were done in April, 2020, representing 9·5% of those done in April, 2019 (n=110 584), before recovering to 105 716 by October, 2020 (84·5% of those done in October, 2019 [n=125 072]). Recovering to 100% capacity on the current trajectory would lead to a projected backlog of 162 735 (95% CI 143 775-181 695) colonoscopies, 119 025 (107 398-130 651) flexible sigmoidoscopies, and 194 087 (172 564-215 611) gastroscopies in January, 2021, attributable to the pandemic. Increasing capacity to 130% would still take up to June, 2022, to eliminate the backlog. A further 2-month interruption would add an extra 15·4%, a 4-month interruption would add an extra 43·8%, and a 6-month interruption would add an extra 82·5% to the potential backlog. FIT triaging of cases that are found to have greater than 10 µg haemoglobin per g would reduce colonoscopy referrals to around 75% of usual levels, with the backlog cleared in early 2022. INTERPRETATION: Our work highlights the impact of the pandemic on endoscopy services nationally. Even with mitigation measures, it could take much longer than a year to eliminate the pandemic-related backlog. Urgent action is required by key stakeholders (ie, individual NHS trusts, Clinical Commissioning Groups, British Society of Gastroenterology, and NHS England) to tackle the backlog and prevent delays to patient management. FUNDING: Wellcome/EPSRC Centre for Interventional and Surgical Sciences (WEISS) at University College London, National Institute for Health Research University College London Hospitals Biomedical Research Centre, and DATA-CAN, Health Data Research UK.


Subject(s)
COVID-19 , Capacity Building , Endoscopy, Digestive System , Gastrointestinal Diseases , Procedures and Techniques Utilization , Triage , COVID-19/epidemiology , COVID-19/prevention & control , Capacity Building/methods , Capacity Building/organization & administration , Change Management , Endoscopy, Digestive System/methods , Endoscopy, Digestive System/statistics & numerical data , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/therapy , Humans , Immunochemistry , Infection Control , Outcome and Process Assessment, Health Care , Procedures and Techniques Utilization/statistics & numerical data , Procedures and Techniques Utilization/trends , SARS-CoV-2 , State Medicine/organization & administration , State Medicine/trends , Triage/methods , Triage/statistics & numerical data , United Kingdom/epidemiology , Waiting Lists
14.
World J Gastroenterol ; 27(13): 1255-1266, 2021 Apr 07.
Article in English | MEDLINE | ID: covidwho-1175603

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can progress to a severe respiratory and systemic disease named coronavirus disease-2019 (COVID-19). The most common symptoms are fever and respiratory discomfort. Nevertheless, gastrointestinal infections have been reported, with symptoms such as diarrhea, nausea, vomiting, abdominal pain, and lack of appetite. Importantly, SARS-CoV-2 can remain positive in fecal samples after nasopharyngeal clearance. After gastrointestinal SARS-CoV-2 infection and other viral gastrointestinal infections, some patients may develop alterations in the gastrointestinal microbiota. In addition, some COVID-19 patients may receive antibiotics, which may also disturb gastrointestinal homeostasis. In summary, the gastrointestinal system, gut microbiome, and gut-lung axis may represent an important role in the development, severity, and treatment of COVID-19. Therefore, in this review, we explore the current pieces of evidence of COVID-19 gastrointestinal manifestations, possible implications, and interventions.


Subject(s)
COVID-19 , Gastrointestinal Diseases , Gastrointestinal Microbiome , Gastrointestinal Diseases/therapy , Humans , SARS-CoV-2
16.
Ital J Pediatr ; 47(1): 71, 2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1150410

ABSTRACT

Gastrointestinal diseases such as celiac disease, functional gastrointestinal disorders (FGIDs), inflammatory bowel disease (IBDs) and acute or chronic diarrhea are quite frequent in the pediatric population. The approach, the diagnosis and management can be changed in the 2019 coronavirus disease (COVID-19) pandemic era. This review has focused on: i) the current understanding of digestive involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected children and adolescents and the clinical implications of COVID-19 for pediatric gastroenterologists, ii) the impact of COVID-19 on the clinical approach to patients with pre-existing or onset diseases, including diagnosis and treatment, and iii) the role and limited access to the instrumental diagnosis such as digestive endoscopy. To date, it is unclear if immunosuppression in patients with IBD and chronic liver disease represents a risk factor for adverse outcomes. Scheduled outpatient follow-up visits may be postponed, especially in patients in remission. Conversely, telemedicine services are strongly recommended. The introduction of new therapeutic regimens should be made on an individual basis, discussing the benefits and risks with each patient. Furthermore, psychological care in all children with chronic disease and their parents should be ensured. All non-urgent and elective endoscopic procedures may be postponed as they must be considered at high risk of viral transmission. Finally, until SARS-CoV-2 vaccination is not available, strict adherence to standard social distancing protocols and the use of personal protective equipment should continue to be recommended.


Subject(s)
COVID-19/complications , Gastrointestinal Diseases/virology , Infection Control/organization & administration , Adolescent , Child , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/therapy , Humans , SARS-CoV-2
17.
Expert Rev Gastroenterol Hepatol ; 15(7): 743-757, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1120754

ABSTRACT

Introduction: Gastrointestinal diseases due to infectious pathogens currently represent an important global health concern, especially in children and developing countries. Early and accurate detection of gastrointestinal pathogens is important to initiate the appropriate type of therapy. Multiplex molecular gastrointestinal panels rapidly detect several gastrointestinal pathogens at once with high sensitivity.Areas covered: We assess the scope and limitations of several multiplex gastrointestinal panels approved by the Food and Drug Administration or marked by Conformité Européenne-in vitro diagnostic. We compare 10 syndromic gastrointestinal panels, 14 bacteria-specific multiplex panels, seven parasite-specific multiplex panels, and eight virus-specific multiplex panels.Expert opinion: Thanks to the advances made in the diagnostic approaches for gastrointestinal infections, there are various panels to choose. The choice of a specific syndromic gastrointestinal multiplex panel should be made to improve patient care. Diagnostic syndromic multiplex approaches for gastrointestinal infections should be customized; each hospital should develop its diagnostic algorithm for gastrointestinal infections tailored to its setting, study population, and geographical site. Current multiplex gastrointestinal panels could be improved by including the detection of antimicrobial resistance, toxigenic Clostridioides difficile, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the virus responsible for the COVID-19 pandemic).


Subject(s)
Communicable Diseases/diagnosis , Gastrointestinal Diseases/diagnosis , Molecular Diagnostic Techniques , Bacteriological Techniques , COVID-19/diagnosis , COVID-19/virology , COVID-19 Testing , Clinical Decision-Making , Communicable Diseases/etiology , Communicable Diseases/therapy , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/therapy , Humans , Parasitology , Predictive Value of Tests , Prognosis
18.
J Med Case Rep ; 15(1): 60, 2021 Feb 08.
Article in English | MEDLINE | ID: covidwho-1069584

ABSTRACT

BACKGROUND: To investigate the potential beneficial effect of fecal microbiota transplantation (FMT) on gastrointestinal symptoms, gut dysbiosis and immune status in discharged COVID-19 patients. CASE PRESENTATION: A total of 11 COVID-19 patients were recruited in April, 2020, about one month on average after they were discharged from the hospital. All subjects received FMT for 4 consecutive days by oral capsule administrations with 10 capsules for each day. In total, 5 out of 11 patients reported to be suffered from gastrointestinal symptoms, which were improved after FMT. After FMT, alterations of B cells were observed, which was characterized as decreased naive B cell (P = 0.012) and increased memory B cells (P = 0.001) and non-switched B cells (P = 0.012).The microbial community richness indicated by operational taxonomic units number, observed species and Chao1 estimator was marginally increased after FMT. Gut microbiome composition of discharged COVID-19 patients differed from that of the general population at both phylum and genera level, which was characterized with a lower proportion of Firmicutes (41.0%) and Actinobacteria (4.0%), higher proportion of Bacteroidetes (42.9%) and Proteobacteria (9.2%). FMT can partially restore the gut dysbiosis by increasing the relative abundance of Actinobacteria (15.0%) and reducing Proteobacteria (2.8%) at the phylum level. At the genera level, Bifidobacterium and Faecalibacterium had significantly increased after FMT. CONCLUSIONS: After FMT, altered peripheral lymphocyte subset, restored gut microbiota and alleviated gastrointestinal disorders were observe, suggesting that FMT may serve as a potential therapeutic and rehabilitative intervention for the COVID-19.


Subject(s)
B-Lymphocyte Subsets , COVID-19/complications , Dysbiosis/therapy , Fecal Microbiota Transplantation , Gastrointestinal Diseases/therapy , Gastrointestinal Microbiome , Aged , Bacteroidetes , Bifidobacterium , COVID-19/immunology , Dysbiosis/microbiology , Faecalibacterium , Female , Gastrointestinal Diseases/microbiology , Humans , Male , Middle Aged , Patient Discharge , Proteobacteria , SARS-CoV-2 , Young Adult
19.
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)
COVID-19 , Gastroenterology/methods , Gastrointestinal Diseases , COVID-19/complications , COVID-19/diagnosis , COVID-19/therapy , COVID-19 Testing , 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
20.
J Gastroenterol Hepatol ; 36(6): 1414-1422, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-991519

ABSTRACT

BACKGROUND AND AIM: A worldwide outbreak of coronavirus disease 2019 (COVID-19) has drawn global attention. Several reports have described the gastrointestinal (GI) manifestations in the infected patients. The systematic review was designed to highlight the gaps in our knowledge about the prevalence and clinical significance of GI symptoms in patients with COVID-19. METHODS: We searched PubMed database and Google articles published in both English and Chinese up to June 3, 2020, using search terms "clinical features," "2019 novel coronavirus," "2019-nCoV," "COVID-19," or "SARS-Cov-2." Observational studies, case reports, or letters describing the clinical features or observational studies regarding the detection and/or isolation of severe acute respiratory syndrome coronavirus 2 viruses in stools were included. RESULTS: A total of 22 publications were finally selected. It was reported that GI symptoms occurred in about 3-40.7% of patients. GI manifestations included nausea, diarrhea, anorexia, vomiting, abdominal pain, belching, abdominal distension, and GI hemorrhage. Diarrhea was the most common GI symptom. Infected patients had various degrees of liver dysfunction, and the severity of liver dysfunction was significantly associated with the severity of the disease. Therapy focusing on digestive system like liver supportive therapy or nutrition support or probiotics has been demonstrated to be effective interventions, which greatly improve prognosis. Fecal-oral transmission route is a potential risk for transmission. CONCLUSIONS: GI symptoms are common in COVID-19. Strengthening the recognition on abnormalities in digestive system of patients with COVID-19 is crucial for early identification and timely treatment, especially for those atypical patients. Hygiene protection and keeping the drainpipe free flowing are necessary for everyone.


Subject(s)
COVID-19 , Disease Transmission, Infectious/prevention & control , Gastrointestinal Diseases , COVID-19/physiopathology , COVID-19/prevention & control , COVID-19/transmission , Disease Management , Gastrointestinal Diseases/epidemiology , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/physiopathology , Gastrointestinal Diseases/therapy , Humans , Prevalence , SARS-CoV-2
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