COVID-19 Pandemic is generally recognized as pneumonia but can also cause various digestive system disorders, symptoms, and damage to digestive organs. Hence, it has caused many clinical issues related to gastroenterology and the overall human digestive system that includes management of gastrointestinal (GI) symptoms related to COVID-19 Pandemic, fecal-oral transmission route, nutrition support during COVID-19 Pandemic treatment, adverse reactions of the therapeutic drugs, and infection control of digestive endoscopy during COVID-19 Pandemic.
According to various studies, it has shown that patients with COVID-19 positive have complained of digestive symptoms such as nausea, diarrhea, poor appetite, vomiting, abnormal liver enzymes, inflammatory bowel disease, and exacerbation of symptoms. In addition, patients have also complained of loss of smell which is the second most common cause of the Corona virus, accounting for approximately 12% of all reported cases all over the globe.
During the COVID-19 Pandemic, patients admitted to an emergency, general, and digestive specialist clinics must be tested for suspected COVID-19 by exposing their medical history, body temperature, chest ST to control cross-infection, and NP swab for PCR. It is mandatory that the medical staff must have corresponding knowledge regarding the consultation process and pay special attention to the screening of COVID-19 patients.
Main Clinical Findings of COVID-19 in Digestive System
Gastroenterologists should known the impact of COVID-19 on the digestive system has shown a range of changes and symptoms that many elderly and middle-aged people have reported. COVID-19 is a respiratory illness caused by an unknown virus.
What Should Patients Know About The Disease?
First of all, everyone should know that it is a rapidly evolving area where a new piece of information emerges on daily basis. Therefore, patients and physicians must check out the latest recommendation and findings from the leading news portals and international health organizations such as WHO & CDC. It is the most important approach for both parties to stay informed regarding accurate information.
Digestive Endoscopy in COVID-19 Pandemic
Digestive endoscopy directly contacts the mucosal secretion and luminal discharge, and impacts the throat, and cause gagging, choking, vomiting, and coughing. During COVID-19 Pandemic, it is highly recommended to the physicians to delay the elective procedures. Surgical procedures that are conducted by using general anaesthesia should also be suspended because of the higher risk involved. Apart from the general SOPs followed in the endoscopic area, extra cautions need to taken in cleaning and buffering the area, while ensuring a separate flow line for staff from the line of patients flow. It has been declared mandatory to go for screening before any surgical treatment is conducted. Patients must be negative in all those primary tests like nasopharyngeal swab acid test, lung CT SARS specific antibody test. After the clearing of primary screening reports, the staff of the gastroenterology department should ensure the SOPs of secondary protection by wearing surgical masks, gowns with shoe covers, face shields, and disposable hats and gloves. In the unfortunate case of the covid-19 positive patient, an isolated endoscopic operating room should be selected for diagnosis and procedure. The medical team in this scenario would be asked to add a comprehensive respiratory protective device for their safety purpose. Equipment and procedure room should be disinfected according to the SOPs after the procedure.
Gastroenterologists should know that gastrointestinal and liver dysfunction is very common in patients suffering from COVID-19. These patients usually don’t show respiratory symptoms. Health care professionals need to have a high level of suspicion for quick and early diagnosis of this deadly viral infection. Since it is still a new virus and not much data is available about its effect on immunocompromised patients so it’s better to take precautionary measures as much as possible. Patients, who are suffering from chronic diseases of liver or inflammatory bowl, should be kept in close scrutiny. Their routine medications should neither be stopped nor reduced. Medication for those patients who are suffering from covid-19 and taking immunosuppressants should get their dosage of steroids adjusted with the help of a pharmacist and consultation of the gastroenterologist.
It has been cited by the association of the American gastroenterology that gastroenterologists will have to face high-risk factors in endoscopic procedures due to aerosol generation in these treatments. Doctors and all other health care professionals involved in these operations make it necessary for them to wear personal protection equipment including an N95 mask and double gloves.