PMC:7212965 / 5490-8748 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7212965","sourcedb":"PMC","sourceid":"7212965","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7212965","text":"Scope and Purpose\nWe seek to summarize international data on the Gl and liver manifestations of COVID-19 infection and treatment. Additionally, this document provides evidence-based clinical guidance on clinical questions that gastroenterologists may be consulted for. This rapid review document was commissioned and approved by the AGA Institute Clinical Guidelines Committee, AGA Institute Clinical Practice Updates Committee, and the AGA Governing Board to provide timely, methodologically rigorous guidance on a topic of high clinical importance to the AGA members and the public. Table 1 provides a summary of the recommendations and best practice statements.\nTable 1 Summary of Best Practice Statements: Consultative Management of Coronavirus Disease 2019\nStatement no. Statement\n1 In outpatients with new-onset diarrhea, ascertain information about high-risk contact exposure; obtain a detailed history of symptoms associated with COVID-19, including fever, cough, shortness of breath, chills, muscle pain, headache, sore throat, or new loss of taste or smell; and obtain a thorough history for other Gl symptoms, including nausea, vomiting, and abdominal pain.\n2 In outpatients with new-onset Gl symptoms (eg, nausea, vomiting, abdominal pain, and diarrhea), monitor for symptoms associated with COVID-19, as GI symptoms may precede COVID-related symptoms by a few days. In a high COVID-19 prevalence setting, COVID-19 testing should be considered.\n3 In hospitalized patients with suspected or known COVID-19, obtain a thorough history of GI symptoms (ie, nausea, vomiting, abdominal pain, and diarrhea), including onset, characteristics, duration, and severity.\n4 There is presently inadequate evidence to support stool testing for diagnosis or monitoring of COVID-19 as part of routine clinical practice.\n5 In patients (outpatients or inpatients) with elevated LFTs in context of suspected or known COVID-19, evaluate for alternative etiologies.\n6 In hospitalized patients with suspected or known COVID-19, obtain baseline LFTs at the time of admission and consider LFT monitoring throughout the hospitalization, particularly in the context of drug treatment for COVID-19\n7 In hospitalized patients undergoing drug treatment for COVID-19, evaluate for treatment-related Gl and hepatic adverse effects.\n\nPanel Composition and Conflict of Interest Management\nThis rapid review and guideline was developed by gastroenterologists and guideline methodologists from the 2 AGA committees. The guideline panel worked collaboratively with the AGA Governing Board to develop the clinical questions, review the evidence profiles, and develop the recommendations. Panel members disclosed all potential conflicts of interest according to AGA Institute policy.\n\nTarget Audience\nThe target audience of this guideline includes gastroenterologists, advanced practice providers, nurses, and other health care professionals. Patients as well as policy-makers can benefit from these guidelines. These guidelines are not intended to impose a standard of care for individual institutions, health care systems, or countries. They provide the basis for rational informed decisions for clinicians, patients, and other health care professionals in the setting of a 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