AGA issues guideline on COVID-19 case management

The American Gastroenterological Association released a guideline on the consultative management of COVID-19 patients.

Researchers performed a systematic literature search to identify studies on the prevalence of diarrhea, nausea, vomiting, abdominal pain and liver abnormalities. They found gastrointestinal symptoms were associated with COVID-19 patients in less than 10 percent of cases, but noted estimates are higher in studies outside of China.

Here are seven best practices to implement for the consultative management of COVID-19:

1. In patients with new-onset diarrhea, clinicians should determine if patients had high-risk contact exposure to COVID-19 and obtain a detailed history of COVID-19-related and GI-related symptoms.

2. In patients with new-onset GI symptoms, clinicians should monitor for symptoms of COVID-19 over the next few days. GI symptoms occasionally precede other COVID-19 symptoms by a few days. If the patient is in a high-risk area, clinicians should consider testing them for COVID-19.

3. In hospitalized patients with COVID-19, clinicians should obtain a history of GI symptoms.

4. Researchers did not find enough evidence to recommend stool testing for diagnosis or monitoring of COVID-19 patients.

5. In patients with elevated liver function tests and suspected COVID-19, clinicians should evaluate for alternative etiologies.

6. In patients hospitalized with COVID-19, clinicians should obtain a baseline liver function test at the time of admission and consider monitoring liver function throughout COVID-19 treatments.

7. In hospitalized patients undergoing drug treatments for COVID-19, clinicians should evaluate patients for treatment-related GI adverse effects.

Researchers concluded, "Further studies are needed with standardized GI symptoms questionnaires and [liver function test] checks on admission to better quantify and qualify the association of these symptoms with COVID-19."

Read the entire guideline here. 

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