COVID-19 status quo: Emphasis on gastrointestinal and liver manifestations

The coronavirus disease 2019 (COVID-19) has caused one of the worst public health crises in modern history. Even though severe acute respiratory syndrome coronavirus 2 primarily affects the respiratory tract, gastrointestinal manifestations are well described in literature. This review will discuss the epidemiology, virology, manifestations, immunosuppressant states, and lessons learned from COVID-19. Observations: At the time of writing, COVID-19 had infected more than 111 million people and caused over 2.5 million deaths worldwide. Multiple medical comorbidities including obesity, pre-existing liver condition and the use of proton pump inhibitor have been described as risk factor for severe COVID-19. COVID-19 most frequently causes diarrhea (12.4%), nausea/vomiting (9%) and elevation in liver enzymes (15%-20%). The current data does not suggest that patients on immunomodulators have a significantly increased risk of mortality from COVID-19. The current guidelines from American Gastroenterological Association and American Association for the Study of Liver Diseases do not recommend pre-emptive changes in patients on immunosuppression if the patients have not been infected with COVID-19. Conclusions and relevance: The COVID-19 pandemic has prompted a change in structure and shape of gastroenterology departmental activities. Endoscopy should be performed only when necessary and with strict protective measures. Online consultations in the form of telehealth services and home drug deliveries have revolutionized the field.

Automated summary

COVID-19 has caused a severe public health crisis, infecting over 111 million people worldwide and leading to more than 2.5 million deaths. The virus primarily affects the respiratory tract but can also cause gastrointestinal symptoms. Medical comorbidities and certain medications have been identified as risk factors for severe COVID-19, but immunosuppressive therapy does not appear to significantly increase mortality risk. The pandemic has brought changes to gastroenterology departments, with a shift towards more necessary endoscopies and the utilization of online consultations and home drug deliveries.