Impact of Corona Virus Disease-19 (COVID-19) pandemic on gastrointestinal disorders

Abstract

Worldwide, several hospitals in different regions and countries have been affected with Corona Virus Disease-19 (COVID-19). All medical specialties including gastroenterology are impacted by COVID-19. Here, we review the bidirectional comorbidity of chronic gastrointestinal (GI) disorders and COVID-19, including the incidence and outcome of COVID-19 in individuals with various GI disorders and the impact of COVID-19 on the course and outcome of the underlying (or comorbid) GI disorders. Currently, there is no evidence that COVID-19 is more (or less) frequent in comorbid GI disorders. It is also reassuring that the outcome of COVID-19 is unaffected by the underlying GI disorder or its treatment, though potential concerns remain in regard to the use of immunomodulatory treatments in inflammatory bowel disease (IBD) and liver transplant recipients. Despite these concerns, there is now agreement among experts that ongoing immunomodulatory treatments may not be interrupted in individuals with IBD during the COVID-19 pandemic. Caution, however, may be exercised with the use of corticosteroids in the management of IBD. In addition, COVID-19 does not appear to impact the manifestations, course, outcome, and treatment of comorbid GI disorders, e.g. IBD. Decompensation of liver cirrhosis is, however, possible during COVID-19 episodes. A direct concern, however, might relate to the potential transmission of the virus through fecal microbiota transplants.

Keywords: COVID-19; Comorbidity; Corona Virus; Crohn disease; Diarrhea; Immunosupression; Inflammatory bowel disease; Pandemic; Ulcerative colitis.

Fig. 1

Cartoon depicting the possible relationship between inflammatory bowel disease and Corona Virus Disease-19 (COVID-19). ACE-2 angiotensin-converting enzyme type 2