The daily impact of COVID‐19 in gastroenterology

Abstract

A new strain of coronavirus, called SARS-CoV-2, emerged in Wuhan, China, in December 2019, probably originating from a wild-animal contamination. Since then, the situation rapidly evolved from a cluster of patients with pneumonia, to a regional epidemic and now to a pandemic called COrona VIrus Disease 2019 . This evolution is related to the peculiar modes of transmission of the disease and to the globalization and lifestyle of the 21st century that created the perfect scenario for virus spread. Even though research has not evidenced particular susceptibility of inflammatory bowel disease (IBD) patients to SARS-CoV-2 infection, immunosuppressive and immunomodulatory treatments were considered potential risk factors. In this context, initiating treatments with these agents should be cautiously weighted and regular ongoing treatments shall be continued, while the dose of corticosteroids should be reduced whenever possible. Due to the increased risk of contamination, elective endoscopic procedures and surgeries should be postponed and IBD online appointments shall be considered. IBD patients shall also follow the recommendations provided to the general population, such as minimization of contact with infected or suspected patients and to wash hands frequently. In the absence of effective treatments and vaccines, this pandemic can only be controlled through prevention of SARS-CoV-2 transmission with the main objectives of providing patients the best healthcare possible and reduce mortality.

Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden

“…[4][5][6][7] The Pennsylvania SAHO effectively cancelled elective procedures and severely curtailed inpatient and outpatient medical visits to increase hospital capacity to care for COVID-19 patients and reduce viral spread by limiting contact in high-risk locations. 8,9 Concurrently, emergency department (ED) visits nationwide declined abruptly, a trend noted globally as well. [10][11][12][13][14][15][16] The decline in ED visits was ascribed to patient fear of contracting SARS-CoV-2 infectionda fear that seemed unimpacted by nonviral acute illness.…”

The Impact of SARS-CoV-2 on Inflammatory Bowel Disease

“…However, the impact of immunosuppression on the susceptibility to COVID-19 is still unclear. Data reported thus far did not identify immunomodulator use as a risk factor for disease severity [7,13], even though a decreased host immune surveillance could theoretically increase virus burden. Also, groups with relative immunosuppression, like pregnant women and HIV patients, do not appear to be more prone to complications [14].…”

“…Notwithstanding, as it happens for all medical conditions, IBD management faces unprecedented challenges. In order to avoid any potential loss of followup, virtual clinical appointments must be conducted whenever possible, yet routine blood assessments may be deferred [13].…”

“…In addition, considering the possibility of a fecal-oral route, the fact that SARS-CoV-2 may be transmittable by surfaces or objects and that aerosolization during invasive procedures may promote spread through the airborne route [19], all elective endoscopies and surgeries must be postponed. In case of emergent procedures, it is advisable, when possible, to test patients for SARS-CoV-2 [13]. Besides this, whenever a respiratory infection is suspected, procedures must be performed in a negative pressure room, with a 30-min interval among one patient's exit and the entrance of the next [19].…”

Effect of COVID-19 pandemic on workflows and infection prevention strategies of endoscopy units in Hungary - a cross-sectional survey

“…15 COVID-19 is easily inactivated by commonly used disinfectants such as alcohol or chlorine-based solutions; therefore, no change in standard protocol is required in cleaning of endoscopes and reusable accessories. 9,16 Full PPE includes disposable hair net, face shield/goggles, surgical masks or FFP-2/3 masks (depending on the patient's risk for infection), water-proof disposable gowns and gloves. In contrast, a survey carried out at the rst weeks of pandemic in the United States highlighted that universal use of FFP-2/3 masks were used in only 65% of cases.…”