Twelve Months with COVID-19: What Gastroenterologists Need to Know
Giulia Concas1, Michele Barone2, Ruggiero Francavilla3
1School of Paediatrics, University of Cagliari, 09124, Cagliari, Italy.
Insights
This review provides physicians with guidance on managing patients with chronic gastrointestinal diseases during the COVID-19 pandemic, focusing on SARS-CoV-2 transmission and liver involvement. It summarizes current guidelines for gastrointestinal procedures and immunosuppressive treatments.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Hepatology
Background:
- Coronavirus disease-19 (COVID-19) is a global pandemic.
- COVID-19 presents with respiratory, gastrointestinal symptoms (GIS), and liver involvement.
- A significant percentage of COVID-19 patients exhibit GIS, necessitating specific clinical guidance.
Purpose of the Study:
- To provide physicians with a practical reference for managing patients with chronic gastrointestinal diseases during the COVID-19 pandemic.
- To summarize current data on SARS-CoV-2 origin, pathogenesis, and gastrointestinal manifestations.
- To outline updated guidelines for gastrointestinal procedures and immunosuppressive treatments in the context of COVID-19.
Main Methods:
- Literature search up to December 2020.
- Review of clinical manifestations of gastrointestinal involvement in COVID-19.
- Synthesis of recent guidelines on GI procedures (endoscopy, liver biopsy, fecal transplantation) and immunosuppressive therapy.
- Focus on special conditions like fecal-oral transmission and gut microbiota.
Main Results:
- COVID-19 transmission primarily occurs via respiratory droplets, but gastrointestinal symptoms and liver involvement are common.
- Guidelines for safe execution of GI procedures, social distancing, and management of immunosuppressive treatments are presented.
- Special considerations for fecal-oral transmission and the role of gut microbiota in COVID-19 are discussed.
Conclusions:
- Managing patients with chronic GI diseases during the COVID-19 pandemic requires updated clinical knowledge and adherence to specific guidelines.
- Understanding SARS-CoV-2's gastrointestinal and hepatic manifestations is crucial for patient care.
- The review serves as an essential resource for medical consultation and patient management amidst rapidly evolving information on COVID-19.
Abstract:
Corona virus disease-19 (COVID-19) is the latest global pandemic. COVID-19 is mainly transmitted through respiratory droplets and, apart from respiratory symptoms, patients often present with gastrointestinal symptoms and liver involvement. Given the high percentage of COVID-19 patients that present with gastrointestinal symptoms (GIS), in this review, we report a practical up-to-date reference for the physician in their clinical practice with patients affected by chronic gastrointestinal (GI) diseases (inflammatory bowel disease, coeliac disease, chronic liver disease) at the time of COVID-19. First, we summarised data on the origin and pathogenetic mechanism of SARS-CoV-2. Then, we performed a literature search up to December 2020 examining clinical manifestations of GI involvement. Next, we illustrated and summarised the most recent guidelines on how to adhere to GI procedures (endoscopy, liver biopsy, faecal transplantation), maintaining social distance and how to deal with immunosuppressive treatment. Finally, we focussed on some special conditions such as faecal-oral transmission and gut microbiota. The rapid accumulation of information relating to this condition makes it particularly essential to revise the literature to take account of the most recent publications for medical consultation and patient care.
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