Objective Postinfectious irritable bowel syndrome (IBS) is a known entity. We evaluated the incidence of post-COVID-19 IBS in patients discharged from the hospital and analyzed its correlation with the clinical and laboratory parameters, and treatment during the hospital stay. Methods Three hundred three COVID-19 hospitalized patients without prior history of IBS were prospectively followed after their discharge and were evaluated as per Rome-IV criteria for IBS. Results One hundred seventy-eight patients were males (58.7%). The age range was 17–95 years (mean ± SD, 55.9 ± 15.8). A total of 194 (64%) had mild COVID-19, 74 (24.4%) had moderate COVID-19, whereas 35 (11.6%) had severe COVID-19 infection. Sixteen (5.3%) patients had concomitant GI symptoms during COVID-19 infection. IBS symptoms were found to be present in 32 (10.6%) patients, out of which 17 (53.13%) had diarrhea-predominant, 10 (31.25%) had constipation-predominant, and five (15.62%) had mixed-type IBS. Post-COVID-19 IBS was more common in the female sex (P < 0.001), concomitant GI symptoms with COVID-19 (P < 0.001), oxygen requirement (P = 0.015), deranged liver function tests at the time of admission (P = 0.002), high procalcitonin (P = 0.013), high C-reactive protein levels (P = 0.035); whereas negative correlation was found with remdesivir treatment (P = 0.047). After performing regression analysis, female sex (P < 0.001), oxygen requirement during hospital stay (P = 0.016), GI symptoms during COVID-19 infection (P < 0.001), and high procalcitonin levels (P = 0.017) were independently associated with post-COVID-19 IBS. Conclusion GI symptoms during active COVID-19 infection increase the chances of developing post-COVID-19 IBS. The risk of developing post-COVID-19 IBS increases in female patients, those requiring oxygen and having high procalcitonin levels during COVID-19 infection.
Objectives: COVID-19 has taken the world by storm, creating much disparity among both healthcare and non-healthcare centres regarding the provision of services. The purpose of our study was to see the prevalence of the SARS-COV-2 exposure in the asymptomatic patients undergoing the endoscopic procedure, already triaged based on history and examination. Methods: Total 207 patients were enrolled during a time period of five months during October 2020 to April 2021 at Dr. Ziauddin Hospital Clifton campus, Karachi. In this prospective observational study patients undergoing endoscopic procedures were included after taking informed consent. The patients who already tested positive for COVID-19 by PCR were excluded. Patients were tested for Covid serology by immunochromatographic rapid serology test (ICT). Standard Operating Procedures for dealing with endoscopy patients during the COVID era were followed in all patients irrespective of antibody status. Results: Total number of patients included was 207; males were 121 (58.5%). The mean age was 48.5 ± 17.55 (range 13 to 92). Forty eight patients (23.2%) were positive for either antibody suggesting exposure to the COVID-19 virus. Out of these combined IgM and IgG positivity was seen in 24 (11.5%), IgM mono antibody positivity was seen in 7 (3.38%) and 17 (8.21%) of the study population tested positive for IgG only. 15 out of 46 (32.6%) patients with chronic liver disease in the cohort were seropositive for COVID antibodies. Conclusion: About one-fourth of the patients undergoing the endoscopic procedure were tested positive for COVID antibodies of which a significant percentage had chronic liver disease. It stresses the need of observing standard precautions to prevent the spread of infection during these procedures, especially in the vulnerable population. doi: https://doi.org/10.12669/pjms.39.2.5659 How to cite this: Altaf A, Abbas Z, Qadeer MA, Siyal M. Point of Care Testing for SARS-COV-2 Antibodies before doing Endoscopy. Pak J Med Sci. 2023;39(2):---------. doi: https://doi.org/10.12669/pjms.39.2.5659 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Regular educational activities have suffered since the start of COVID-19 pandemic. New data has been emerging regularly regarding COVID-19 and the optimal way of care for patients with COVID-19 infection. Emphasis upon dispensing knowledge in current pandemic times should be made. Aims and Objective: We assessed the knowledge of internal medicine and gastroenterology trainees regarding liver involvement and related issues in the current COVID-19 pandemic. Materials and Methods: This online survey comprised of 10 questions designed to examine the basic knowledge of Sars-Cov-2 virus, knowledge regarding liver involvement in COVID-19, and the ability to decide on patient care. Results: A total of 100 responses were collected. Most of the responses were from Pakistan (n=75). More than 80% of trainees responded correctly regarding the accurate indication of endoscopic procedures during COVID-19 pandemic, absence of ACE-II receptor expression on astrocytes, upper respiratory secretions being an eligible sample for SARSCOV- II, avoiding regular outpatient follow up, avoiding hydroxychloroquine as a prophylactic drug, and azithromycin in decompensated cirrhosis, continuing beta-blockers and lactulose in a decompensated patient, melena being an accurate indication for screening endoscopy and the choosing right set of PPEs. Less than 50% of responders knew correctly regarding NAFLD being a notorious factor for COVID-19 related complications, ACE-II receptor expression by cholangiocytes and enterocytes, saliva and stool being an eligible sample for SARS-COV-II detection, palliative approach as an appropriated management step for decompensated-CLD patients and history of ascites as an appropriate indication for screening endoscopy. GItrainees performed better in some areas of knowledge. Conclusions: Trainees were updated in many aspects of the recent guidance in the management of COVID-19 but there were many lacunae in the knowledge. So, continuous medical education activities are essential to keep the residents updated about the changing developments in the management of COVID-19.
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