Direct management : If immunosuppressants are taken, a careful monitoring should be offered if the patient show signs and symptoms suggestive for Covid-191. Temporarily withhold immunomodulators seems to be a reasonable strategy2-3. However, in a systematic review, 27% of patient who discontinued TNFa-inhibitor had IBD relapse after one year. This could lead to higher frequentation medical institutions […]
No increased risk of contracting Covid-19 have been proved for patients with inflammatory bowel disease (IBD) with present available data1. Potential risk factors of SARS-CoV-2 infection for IBD patients is suspected if 2 : Immunosuppressive agents are taken The disease is in an active-stage combined with malnutrition Patient frequently visits medical clinic Underlying health conditions are […]
17% of the patients had abnormal lipase or amylase. Though no histopathological abnormalities were observed in pancreas of deceased patients, ACE2, a known receptor used by SARS-CoV2 to enter cells, is highly expressed in pancreas islets. Pancreatic injury could be related to local cytopathic effect of COVID-19 or systematic response to respiratory failure. Drug-induced pancreatic injury could also explain the phenomenom. […]
The incidence of diarrhea is varying from 2% to 33% and may be underestimated in clinical publications ACE2, a known receptor used by SARS-CoV2 to enter cells, is more expressed in proximal and distal enterocytes SARS-CoV2 appears to invade mucosal cells of the stomach, small intestine and colon where it multiplies and creates virions.2 SARS-CoV […]
Diarrhea, vomiting, and nausea are symptoms identified in 11,4 % of patients.1 A study done in China demonstrated that patients with GI symptoms had a more severe case based on symptoms, radiologic aspect and laboratory results.1 Another study, done in Zhuhai (China), demonstrated that the presence of SARS-CoV-2 RNA in feces does not necessarily correlate with more severe GI […]
Clinical parameters and known mechanisms: The main viral entry receptor of COVID19 is angiotensin converting enzyme 2 (ACE2). Because this receptor is expressed in different organs, like the liver, SARS-CoV-2 causes a systemic disease1. 14% to 53%of hospitalized patients with COVID-19 show elevated serum liver biochemistries such as ALT, AST and […]
Upper gastrointestinal (GI) endoscopy is a high-risk procedure. All patients scheduled for endoscopy should be classified according to their risk of COVID-19 based on the presence of respiratory symptoms, risk contacts and recent travel. AGA recommends wearing N95 instead of the surgical mask for upper and lower endoscopy. AGA recommends wearing double gloves for all endoscopies. Endoscopies should […]
Fecal samples for SARS-CoV-2 RNA remained positive for around 11,2 days after negative respiratory tract samples for SARS-CoV-2 RNA. Precautions should be installed as fecal-oral transmission remains possible, even after a clearance in the respiratory tract is proven. Compared to a respiratory tract sample, a fecal sample can take longer to turn positive. Testing of […]
