15 reports on COVID-19 from the world of gastroenterology
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The first COVID-19 related story concerned with gastroenterology was published in Healio Gastroenterology and Liver Disease on March 6. Since then, we have published more than a dozen articles and posted numerous videos from leaders in the GI community about how the pandemic has impacted clinical practice and how it might change things going forward.
Here, we present our written coverage in one place, starting with our first report from the beginning of March.
Patients with COVID-19 may experience GI symptoms, possible fecal-oral transmission
Results from two studies published in Gastroenterology discussed manifested gastrointestinal symptoms and possible fecal-oral transmission in patients with COVID-19, the disease caused by the novel coronavirus.
“Amounting evidence from former studies of SARS indicated that the gastrointestinal tract (intestine) tropism of SARS coronavirus (SARS-CoV) was verified by the viral detection in biopsy specimens and stool, even in discharged patients, which may partially provide explanations for the gastrointestinal symptoms, potential recurrence and transmission of SARS from persistently shedding human as well,” Jinyang Gu, MD, of the department of transplantation, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and colleagues wrote in one of the studies. READ MORE
Q&A: What GIs need to know about COVID-19
Healio Gastroenterology and Liver Disease talked with our Chief Medical Editor, Edward V. Loftus, MD, from Mayo Clinic in Rochester, Minnesota, about COVID-19 and what the GI community needs to do to address the growing panic. READ MORE
Crohn’s and Colitis Foundation issues guidance on COVID-19 for patients with IBD
The Crohn’s and Colitis Foundation issued guidelines for patients with IBD to protect themselves from COVID-19 such as talk with their gastroenterologist about medications, their health status and any precautions they should take related to COVID-19.
According to the guidance, patients should get information from either the CDC or their local health department websites for specific guidance for local risk and precautions within their community. READ MORE
GI societies provide clinical insights on COVID-19
Four major gastroenterological societies joined together to provide some clinical insights about COVID-19 as the United States responds to the epidemic.
The American Association for the Study of Liver Diseases, The American College of Gastroenterology, The American Gastroenterological Association and the American Society for Gastrointestinal Endoscopy issued a joint message to keep their members up to date on the necessary information on the disease to promote health and safety for patients, staff and providers. READ MORE
Diarrhea may be common symptom in patients with COVID-19
Digestive symptoms were common in patients with COVID-19, according to the American Journal of Gastroenterology. Patients with these symptoms had a longer time from onset to admission and their prognosis was worse compared with patients without symptoms.
“Clinicians should recognize that digestive symptoms, such as diarrhea, may be a presenting feature of COVID-19, and that the index of suspicion may need to be raised earlier in at-risk patients presenting with digestive symptoms rather than waiting for respiratory symptoms to emerge,” Lei Pan, MD, PhD, from the department of Respiratory and Critical Care Medicine at Binzhou Medical University Hospital and the Second Medical Center & National Clinical Research Center for Geriatric Diseases at the Chinese PLA General Hospital, and colleagues wrote. “However, further large sample studies are needed to confirm these findings.” READ MORE
Guest Commentary: Gastrointestinal endoscopy during a global pandemic
In this guest commentary, Farhan Quader, MD, of Washington University School of Medicine, and Zachary Smith, DO, of Case Western Reserve School of Medicine, discuss how endoscopists should navigate the COVID-19 pandemic.
During the modern era of GI endoscopy, we have not encountered a global outbreak of a pandemic virus to which nobody on Earth possesses immunity. The practice of GI endoscopy will continue to evolve dramatically as this COVID-19 pandemic progresses. In its simplest terms, there are two main forces that drive this evolution: the first is the need to mitigate patient traffic from the community or inpatient units into the endoscopy unit; the second is to conserve personal protective equipment (PPE) as institutional shortages become inevitable. During this crisis, many patients will require urgent, or semi-urgent endoscopy, some of whom will be suspected or confirmed to have COVID-19. There is substantial guidance available from our GI societies, as well as from international centers that have faced this crisis firsthand. READ MORE
Q&A: New registry aims to report COVID-19 outcomes among IBD patients
As COVID-19 continues to spread, gastroenterologists are assessing how the virus impacts patients with inflammatory bowel disease.
Recently the Surveillance Epidemiology of Coronavirus Under Research Exclusion-IBD (SECURE-IBD) registry was launched. This registry monitors and reports outcomes of COVID-19 in patients with IBD. The registry aims to answer questions patients with IBD and their caregivers may have. READ MORE
Q&A: Social distancing is key to prevent COVID-19 among liver transplant recipients
There are many people in the United States living with liver disease. Patients with liver disease, in particular those who are awaiting a liver transplant, have a higher risk for being affected by COVID-19. Patients who recently received a liver disease diagnosis are also at higher risk because they take immunosuppressants.
Healio Gastroenterology and Liver Disease spoke with Robert Brown Jr, MD, MPH, vice chair of Transitions of Care and Clinical Chief of the Division of Gastroenterology and Hepatology in the Department of Medicine Weill Cornell Medical College and member of the American Liver Foundation’s National Medical Advisory Committee, about considerations for people living with liver disease, proper social distancing practices, hand hygiene etiquette and ways to treat transplant recipients. READ MORE
Q&A: Endoscopists need to prioritize health screenings, procedures during COVID-19 pandemic
With the COVID-19 pandemic, many patients’ previously scheduled health screenings such as cancer screenings and colonoscopies are now being canceled or postponed until further notice. Many centers are prioritizing patients’ procedures as urgent or not.
Healio Gastroenterology and Liver Disease spoke with Glenn Littenberg, MD, chief medical officer of InSite Digestive Health Care in Pasadena, and health policy chair of the Digestive Health Physicians Association, about what screenings endoscopists are postponing, what procedures are considered priority and what precautions endoscopists need to take to prevent the spread of COVID-19. READ MORE
FDA warns about possible SARS-CoV-2, COVID-19 transmission with FMT
The FDA issued a safety alert for the use of fecal microbiota transplantation and the possible risk for transmission of the SARS-CoV-2 virus.
According to the safety alert, various studies have shown SARS-CoV RNA and the SARS-CoV-2 virus present in stools of infected patients, demonstrating that the virus may be transmitted by an FMT. READ MORE
Patients with COVID-19 GI symptoms experience delayed diagnosis, viral clearance
Patients who develop new-onset digestive symptoms, like diarrhea, after a possible exposure to COVID-19 should be suspected for the illness, according to research published in The American Journal of Gastroenterology.
In the study, Xiaohua Hou, MD, PhD, of the division of gastroenterology at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, China, and colleagues wrote that these patients should be suspected for COVID-19 even without common respiratory symptoms, such as cough, shortness of breath, sore throat or fever. READ MORE
Q&A: New York GIs on how to prevent spread of COVID-19
As one of the states hit hardest by the COVID-19 pandemic, New York has had to make many changes to reduce spread of the virus.
In a recent article published in the American Journal of Gastroenterology, Seth A. Gross, MD, FACG, FASGE, AGAF, the Clinical Chief from the division of Gastroenterology and Hepatology and Associate Professor of Medicine, at NYU Langone Health, and colleagues highlighted recommendations for hospitals and institutions to follow to prevent COVID-19. READ MORE
AGA issues COVID-19 recommendations for PPE use during GI procedures
The American Gastroenterologists Association released COVID-19 recommendations for personal protective equipment use during gastrointestinal procedures.
The recommendations, which were published in Gastroenterology, were approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee and the AGA Governing Board. READ MORE
Q&A: COVID-19 impact on GI, hepatology practices
With the rise of the novel coronavirus in the United States, it is important for hepatologists and gastroenterologists to know how other practices are dealing with the impact of COVID-19. With nationwide shutdowns, medical institutions and practices are finding difficulties in seeing patients and researching drugs.
Healio Gastroenterology and Liver Disease spoke with Stephen A. Harrison, MD, medical director of clinical research at Pinnacle Clinical Research in San Antonio and president of Summit Clinical Research, about how COVID-19 affects patient clinical care, research, best practices and his advice to future medical professionals on how to handle a pandemic. READ MORE
AGA issues new guidance for IBD management during COVID-19 pandemic
The American Gastroenterological Association issued new guidance for the clinical management of patients with inflammatory bowel disease during the COVID-19 pandemic.
“While the COVID-19 pandemic is a global health emergency, patients with IBD have particular concerns for their risk for infection and management of their medical therapies,” the AGA said in a release. “This clinical practice update incorporates the emerging understanding of COVID-19 and summarizes available guidance for patients with IBD and the providers who take care of them.” READ MORE
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