Due to the rapid spread of COVID-19, endoscopy procedures that pertain to IBD have much more stringent requirements and safety protocols in place. Unfortunately, many patients who suffer from IBD are at an elevated risk of contracting COVID-19 due to treatments associated with the disorder. Additionally, endoscopy can be classified as a high risk mode of transmission due to the high risk of aerosol generating actions from patients, such as coughing or gagging.

New Endoscopic Practices Due to COVID-19

Digestive Disease in COVID-19 by Geographic Location 

Patients with digestive diseases like inflammatory bowel disease (IBD) or gastrointestinal cancer are at a higher risk to experience more severe symptoms of COVID-19. Autopsy studies are important in understanding how COVID-19 affects the digestive system. More data needs to be collected to determine the exact relationship between digestive diseases and COVID-19. 

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COVID-19 comorbidities are high risk conditions that put patients at greater risk for infection and negative outcomes. Some COVID-19 comorbidities have been found to be: 
- Cancer 
- Cardiovascular Disease
- Diabetes
- Digestive Diseases
- HIV
- Hypertension
- Immunological Disease
- Liver Injury
- Obesity
- Renal disease
- Respiratory System Disease

COVID-19 Patient Comorbidities

Mao, R., Liang, J., Shen, J., Ghosh, S., Zhu, L., Yang, H., . . . Chen, M. (2020). Implications of COVID-19 for patients with pre-existing digestive diseases. The Lancet Gastroenterology &amp; Hepatology, 5(5), 425-427. doi:10.1016/s2468-1253(20)30076-5
https://www.thelancet.com/journals/langas/article/PIIS2468-1253(20)30076-5/fulltext

Implications of COVID-19 for patients with pre-existing digestive diseases

- AIDS and Behavior
- American Journal of Cancer Research
- American Journal of Hypertension
- American Society of Clinical Oncology Journals
- Annals of Allergy, Asthma & Immunology
- Annals of Internal Medicine
- Annals of Oncology
- Blood Advances
- BMC
- Brain, Behavior, and Immunity
- Cancer Discovery
- Cell Metabolism
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- Clinical Reviews in Allergy & Immunology
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- Cureus
- Diabetes Care
- Diabetes & Endocrinology
- Diabetes & Metabolic Syndrome: Clinical Research & Reviews
- Diabetes, Obesity, and Metabolism
- Diabetes Research and Clinical Practice
- EClinicalMedicine
- European Journal of Cardio-Thoracic Surgery
- European Journal of Clinical Nutrition
- European Respiratory Journal
- Frontiers in Medicine 
- Frontiers in Public Health
- Gut
- Haematologica
- International Journal of Infectious Diseases
- International Journal of Obesity
- Journal of Alzheimer’s Disease
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- Obesity Research & Clinical Practice
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- Proceedings of the National Academy of Sciences 
- Public Library of Science
- The Brazilian Journal of Infectious Diseases
- The Journal of the American Medicine Association Cardiology
- The Journal of Allergy and Clinical Immunology
- The Lancet
- The National Center for Biotechnology Information
- The New England Journal
- Thrombosis Research
- Translational Stroke Research 

COVID-19 Comorbidities References by Journal

COVID-19 may be worse in patients with comorbidities, and this can cause damage to the heart, liver, kidneys, and blood and immune systems. Many patients have had multiple organ failure that started with pneumonia, and became worse when therapeutic effects were unsatisfactory. Comorbidities can cause a patient's deterioration, leading to multiple organ failure. Organ function should be closely monitored and protective measures such as mechanical ventilation, glucocorticoids, antivirals, symptomatic treatments, and anti-shock therapy should be administered if necessary. 

Multiple Organ Injuries in COVID- 19 Patients with Comorbidities

- Implication of Obesity In Patients with COVID-19 
- Obesity in COVID-19 Patients by Geographic Location 
- Risk of Cytokine Storm in Obese COVID-19 Patients
- Higher Concentrations of IL-17 and TNF-α Lead to Greater Respiratory Damage
- Association of Obesity and Age with severe cases of COVID-19
- Association of Obesity and Hospital Stay Length

Obesity as a Comorbidity of COVID-19 

- Hypertension and COVID-19 by Geographic Location
- Hypertension and COVID-19 by Topic

Hypertension as a Comorbidity of COVID-19

- Respiratory System Disease in COVID-19 Patients by Geographic Location 
- Asthma as a Comorbidity of COVID-19

Respiratory System Disease as a Comorbidity of COVID-19

- Clinical Features and Outcomes of Patients With Human Immunodeficiency Virus With COVID-19
- The Burden of COVID-19 in People Living with HIV: A Syndemic Perspective (General Summary of HIV and COVID-19 Interaction)
- Maintaining HIV care during the COVID-19 pandemic
- HIV in COVID-19 Patients by Geographic Location
- COVID-19 and HIV Coinfection

HIV as a Comorbidity of COVID-19

- By country
- Liver Transplantation
- Chronic Liver Disease

Liver Injuries as a Comorbidity of COVID-19 

- This node acts as a general summary of the comorbidity of cancer and COVID-19 from a paper that analyzed many other papers detailing the same thing at its time of release.
- Via a pooled meta-analysis of studies from around the globe analyzing the prevalence of cancer in COVID-19 patients, it was found that the prevalence of cancer in COVID-19 patients is about 2%, which is higher than the overall prevalence of cancer in the population (I think).
- This leads to a hypothesized conclusion that while there is not a lot of data for COVID-19 infection and cancer patients, there is an elevated risk for these patients. However, due to inconclusive and generally lacking data on this topic, this conclusion is not concrete.
- Many major cancer centers worldwide have taken extra precaution when it comes to the treatment of these patients as many cancer treatments (e.g., chemotherapy) weaken the immune system as a side effect.
- There has currently been no order to withhold chemotherapy, radiotherapy, immunotherapy, or delaying adjuvant therapy to treat cancer patients, however extra care must be taken by patients and physicians alike to not allow these high-risk patients to become infected.

Cancer as a Comorbidity of COVID-19 

Digestive Diseases as a Comorbidity of COVID-19

- Cytokine Storm Syndrome
    -  Secondary Haemophagocytic Lymphohistiocytosis
- Common Variable Immunodeficiency 
- Figure illustrating how pathogenic T cells and inflammatory monocytes enter pulmonary circulation and incite an inflammatory storm and immune disorder 
- Severe Combined Immunodeficiency

Immunological Diseases as a Comorbidity of COVID-19

- Prevalence of pathophysiology, prognosis, and practical considerations
- Knowledge in progress
- The link between diabetes and ACE2
- Diabetes in COVID-19 patients by geographic location 
- Degree of Hyperglycemia on COVID-19 mortality
- Diabetes Medication on COVID-19 mortality
- COVID-19 and endocrine diseases. A statement from the European Society of Endocrinology

Diabetes as a Comorbidity of COVID-19

During the COVID-19 era the regular treatment and communication between physicians and patients regarding preexisting comorbidities has been disrupted. New guidelines and safety precautions must be put in place in order for physicians to still treat their patients and treat them through the use of telehealth or other means. While there are a lot of similarities between new communication policies being implemented across different areas of medicine, there are also many differences due to comorbidity specific criteria which facilitates different levels of involvement and communication between physicians and patients.


The comorbidities addressed under this node include:
- Cancer
- Cardiovascular Diseases
- Digestive Diseases
- Elective Surgeries
- Liver Diseases
- Psychological Disorders
- Renal Diseases

Changes to COVID-19 Patient Comorbidity Treatment and Communication

Cardiovascular disease is a risk factor for severe COVID-19, and COVID-19 causes cardiovascular complications. 

Cardiovascular Disease and COVID-19

- A retrospective multi-center experience of renal transplants from India during COVID-19 pandemic

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