JOINT GI SOCIETY MESSAGE: COVID-19 Clinical Insights for Our Community of Gastroenterologists and Gastroenterology Care Providers
The situation involving the COVID-19 pandemic continues to evolve. There is recent evidence suggesting the potential for coronavirus transmission through droplets and perhaps fecal shedding,1,2 posing potential risks during endoscopy and colonoscopy to other patients, endoscopy personnel, and ourselves. We provide below important information as well as recommendations to consider in your institutions and practices that […]

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Hussein Hallak

JOINT GI SOCIETY MESSAGE: COVID-19 Clinical Insights for Our Community of Gastroenterologists and Gastroenterology Care Providers

The situation involving the COVID-19 pandemic continues to evolve. There is recent evidence suggesting the potential for coronavirus transmission through droplets and perhaps fecal shedding,1,2 posing potential risks during endoscopy and colonoscopy to other patients, endoscopy personnel, and ourselves.

We provide below important information as well as recommendations to consider in your institutions and practices that provide endoscopy and outpatient GI services:

What we know:

1.  Cough, fever, fatigue, or sore throat are the most common symptoms in adults

2.  The incidence of GI symptoms including nausea and/or diarrhea are uncertain with some reports below 5% and others at 50%.3,4   There have been some reports of isolated diarrhea preceding cough and fever

3.  The virus may be present in GI secretions and viral RNA is detectable in stool.  Gastrointestinal infection and potential fecal-oral transmission must be considered

4.  Asymptomatic spread can occur during the prodromal phase (the mean incubation period is ~5 days, with a range of 0-14 days), with viral shedding greatest when symptoms begin

5.  Abnormal liver enzymes are observed in 20-30% of persons with COVID-19 infection

6.  Leukocyte counts drop in persons with COVID-19 infection, and elevated WBC is a poor prognostic sign

7.  Older people and those listed by the CDC as vulnerable populations, including severe chronic health conditions, such as heart disease, lung disease, diabetes, decompensated cirrhosis, HIV with low CD4 counts, and immunosuppression, (including liver and other solid organ transplant recipients) are at higher risk of developing more serious illness. Pregnancy may be a risk

8.  Best protection against virus transmission:

  • Wash hands
  • Don’t touch your face
  • Cough etiquette
  • Social distancing
  • Avoid crowds

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