We 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.
Table 1 Summary of Best Practice Statements: Consultative Management of Coronavirus Disease 2019
Statement no. Statement
1 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.
2 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.
3 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.
4 There is presently inadequate evidence to support stool testing for diagnosis or monitoring of COVID-19 as part of routine clinical practice.
5 In patients (outpatients or inpatients) with elevated LFTs in context of suspected or known COVID-19, evaluate for alternative etiologies.
6 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
7 In hospitalized patients undergoing drug treatment for COVID-19, evaluate for treatment-related Gl and hepatic adverse effects.