Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Gastroenterol. 2021 Jan;37(1):23-29. doi: 10.1097/MOG.0000000000000694.
The COVID-19 pandemic has impacted the practicing gastroenterologist in several ways. Although majority of COVID-19 patients present with respiratory symptoms, gastrointestinal symptoms are also seen. COVID-19 has also disrupted gastrointestinal endoscopy services in numerous ways. There are also concerns regarding the impact of these changes on gastrointestinal cancer screening and management of chronic gastrointestinal diseases. The purpose of this review is to provide an overview of the implications of COVID-19 for the practicing gastroenterologist.
COVID-19 patients can have gastrointestinal symptoms including diarrhea, nausea and vomiting, abdominal pain and anorexia. Separate from the management of COVID-19 patients, there has been a reduction in endoscopy volume worldwide. This has also resulted in reduction/cessation of in-person clinic visits and an increasing use of telemedicine services. In addition, patients with certain chronic diseases like chronic liver disease or inflammatory bowel disease may have worse outcomes during the COVID-19 pandemic.
Gastroenterologists need to rapidly adapt to the challenges being faced and need to make both systems and practice-based changes to the endoscopy unit and outpatient clinic practices. Gastroenterologists should stay up-to-date with the rapidly evolving literature regarding gastrointestinal symptoms in COVID-19 patients as well as its impact on chronic gastrointestinal illnesses.
COVID-19 大流行以多种方式影响着执业胃肠病学家。虽然大多数 COVID-19 患者表现为呼吸系统症状,但也存在胃肠道症状。COVID-19 还以多种方式扰乱了胃肠镜服务。人们还担心这些变化对胃肠道癌症筛查和慢性胃肠道疾病的管理产生影响。本文旨在概述 COVID-19 对执业胃肠病学家的影响。
COVID-19 患者可能出现胃肠道症状,包括腹泻、恶心和呕吐、腹痛和食欲不振。除了 COVID-19 患者的治疗之外,全球的内镜检查量已经减少。这也导致了面对面门诊就诊的减少/停止,并越来越多地使用远程医疗服务。此外,某些慢性疾病(如慢性肝病或炎症性肠病)患者在 COVID-19 大流行期间可能会有更糟糕的结局。
胃肠病学家需要迅速适应所面临的挑战,并需要对内镜室和门诊实践进行系统和基于实践的改变。胃肠病学家应及时了解有关 COVID-19 患者胃肠道症状及其对慢性胃肠道疾病影响的快速发展的文献。