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Review
. 2020 Jul;65(7):1932-1939.
doi: 10.1007/s10620-020-06362-8. Epub 2020 May 23.

Clinical Insights into the Gastrointestinal Manifestations of COVID-19

Jonathan Kopel  1 , Abhilash Perisetti  2 , Mahesh Gajendran  3 , Umesha Boregowda  4 , Hemant Goyal  5
Affiliations
Review

Clinical Insights into the Gastrointestinal Manifestations of COVID-19

Jonathan Kopel et al. Dig Dis Sci. 2020 Jul.

Abstract

The month of December 2019 became a critical part of the time of humanity when the first case of coronavirus disease 2019 (COVID-19) was reported in the Wuhan, Hubei Province in China. As of April 13th, 2020, there have been approximately 1.9 million cases and 199,000 deaths across the world, which were associated with COVID-19. The COVID-19 is the seventh coronavirus to be identified to infect humans. In the past, Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome were the two coronaviruses that infected humans with a high fatality, particularly among the elderly. Fatalities due to COVID-19 are higher in patients older than 50 years of age or those with multimorbid conditions. The COVID-19 is mainly transmitted through respiratory droplets, with the most common symptoms being high fever, cough, myalgia, atypical symptoms included sputum production, headache, hemoptysis and diarrhea. However, the incubation period can range from 2 to 14 days without any symptoms. It is particularly true with gastrointestinal (GI) symptoms in which patients can still shed the virus even after pulmonary symptoms have resolved. Given the high percentage of COVID-19 patients that present with GI symptoms (e.g., nausea and diarrhea), screening patients for GI symptoms remain essential. Recently, cases of fecal-oral transmission of COVID-19 have been confirmed in the USA and China, indicating that the virus can replicate in both the respiratory and digestive tract. Moreover, the epidemiology, clinical characteristics, diagnostic procedures, treatments and prevention of the gastrointestinal manifestations of COVID-19 remain to be elucidated.

Keywords: COVID-19; Coronavirus; Gastroenterology; Gastrointestinal symptoms; Pandemic.

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Conflict of interest statement

The authors have no commercial associations or sources of support that might pose a conflict of interest. All authors have made substantive contributions to the study, and all authors endorse the data and conclusions.

Figures

Fig. 1
Fig. 1
Schematic representation of the effects of COVID-19 on enterocytes. COVID-19 enters the mucous membranes and gets access to enterocyte via ACEI II receptors. After entry into the cell, RNA and proteins are produced with the help of ribosomes. Viral capsids, RNA and protein combine to form multiple copies of COVID-19. These viral particles exit the cell and lead to cytokine release (interleukin 2, 7, tumor necrosis factor [ΤΝF] α, macrophage and monocyte products). These cytokines mediate various effects on the gastrointestinal tract
See this image and copyright information in PMC

Comment in

  • Repurposed GI Drugs in the Treatment of COVID-19.
    Aguila EJT, Cua IHY. Aguila EJT, et al. Dig Dis Sci. 2020 Aug;65(8):2452-2453. doi: 10.1007/s10620-020-06430-z. Epub 2020 Jun 29. Dig Dis Sci. 2020. PMID: 32601778 Free PMC article. No abstract available.

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