Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2021; 9(19): 4918-4938
Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.4918
Gastroenterology and liver disease during COVID-19 and in anticipation of post-COVID-19 era: Current practice and future directions
Katerina G Oikonomou, Panagiotis Papamichalis, Tilemachos Zafeiridis, Maria Xanthoudaki, Evangelia Papapostolou, Asimina Valsamaki, Konstantinos Bouliaris, Michail Papamichalis, Marios Karvouniaris, Panagiotis J Vlachostergios, Apostolia-Lemonia Skoura, Apostolos Komnos
Katerina G Oikonomou, Panagiotis Papamichalis, Tilemachos Zafeiridis, Maria Xanthoudaki, Evangelia Papapostolou, Asimina Valsamaki, Apostolos Komnos, Intensive Care Unit, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
Konstantinos Bouliaris, Surgical Department, General Hospital of Larissa, Larissa 41221, Thessaly, Greece
Michail Papamichalis, Department of Cardiology, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
Marios Karvouniaris, Apostolia-Lemonia Skoura, Intensive Care Unit, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
Panagiotis J Vlachostergios, Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY 10065, United States
Apostolia-Lemonia Skoura, Transfusion Medicine Department, University Hospital of Larissa, Larissa 41110, Thessaly, Greece
Author contributions: Zafeiridis T, Papamichalis P and Oikonomou KG designed the review; Papamichalis P and Oikonomou KG analyzed and interpreted the data and wrote the final version of the manuscript; Zafeiridis T, Xanthoudaki M, Papapostolou E, Valsamaki A, Bouliaris K and Skoura AL collected the data and drafted the manuscript; Papamichalis M, Karvouniaris M, Vlachostergios PJ and Komnos A critically reviewed the paper; Oikonomou KG and Vlachostergios PJ performed English editing.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Panagiotis Papamichalis, MD, PhD, Consultant Physician-Scientist, Doctor, Intensive Care Unit, General Hospital of Larissa, Tsakalof 1, Larissa 41221, Thessaly, Greece. ppapamih@med.uth.gr
Received: February 23, 2021
Peer-review started: February 23, 2021
First decision: March 28, 2021
Revised: April 10, 2021
Accepted: May 25, 2021
Article in press: May 25, 2021
Published online: July 6, 2021
Processing time: 121 Days and 5.1 Hours
Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a major threat to global public health. The virus causes the clinical syndrome known as coronavirus disease 2019 (COVID-19), in which multiple organs can get affected. Apart from manifestations of the respiratory system, which predominate, its clinical presentation is frequently accompanied by symptoms of the gastro-intestinal (GI) tract and liver abnormalities. The correlation of symptoms and abnormalities with disease severity is discussed, leading to ambiguous results from international literature. Moreover, the disease infects patients with co-existing liver and GI disorders affecting both their health status and the availability of healthcare services provided to them. The risk of transmission of the disease during aerosol-generating procedures has changed the diagnostic approach and follow-up algorithms for liver and GI diseases. For the safety of both doctors and patients, telemedicine and distant evaluation have become everyday practice, whereas several routines and emergency visits at outpatient and emergency departments have been postponed or delayed. Vaccination against SARS-CoV-2 is underway, providing hope to humanity and the expectation that the post-COVID-19 era is near. This review aims to update knowledge about the manifestations of COVID-19 related to liver and GI diseases and the effect of the pandemic on the diagnostic and therapeutic procedures for these diseases with a special focus on how current practices have changed and what changes will possibly remain in the future.

Keywords: COVID-19; SARS-CoV-2; Liver disease; Gastroenterology practice; Endoscopy

Core Tip: Coronavirus disease 2019 (COVID-19) pandemic has affected every aspect of current medical practice. Patients with gastro-intestinal and liver diseases are not only prone to develop serious complications from COVID-19 but also to have their disease incorrectly or not timely diagnosed and not properly followed up. In this review, we summarize the impact of the pandemic on the course of the disease and the treatment of these patients. In addition, we discuss the changes in everyday practice that were adapted in our effort to protect patients and healthcare workers, with a focus on emerging tools such as telemedicine.