Gastrointestinal Aspects of COVID-19: A Review

Gontar Alamsyah Siregar; Ginanda Putra Siregar; Darmadi Darmadi

doi:10.3889/oamjms.2020.4891

Authors

Gontar Alamsyah Siregar Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Ginanda Putra Siregar Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Darmadi Darmadi Division of Gastroenterohepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.4891

Keywords:

covid-19, Gastrointestinal, SARS-CoV-2

Abstract

Coronaviruses commonly cause mild infections, but recently severe acute respiratory syndrome-coronavirus (SARS-CoV)-2 caused a pandemic of coronavirus disease 2019 (COVID-19). A total of 3,181,642 cases were confirmed globally. Gastrointestinal tract may be involved in COVID-19 due to the presence of angiotensin converting enzyme-2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) in small intestine and colon which are mandatory for SARS-CoV-2 invasion. A proportion of patients with COVID-19 had gastrointestinal manifestation without respiratory symptoms. Viable virus can also be isolated from feces of patients. Fecal-oral transmission should be considered in controlling disease spreading. Fecal examination may also be considered to diagnose COVID-19, especially in areas with limited personal protective equipment.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Cheung KS, Hung IF, Chan PP, Lung K, Tso E, Liu R, et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from the Hong Kong cohort and systematic review and meta-analysis. Gastroenterology. 2020;158:S0016-5085. https://doi.org/10.1053/j. gastro.2020.03.065 PMid:32251668

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi. org/10.1016/s0140-6736(20)30183-5 PMid:31986264

Ng SC, Tilg H. COVID-19 and the gastrointestinal tract: More than meets the eye. Gut. 2020;69(6):973-4. https://doi. org/10.1136/gutjnl-2020-321195 PMid:32273292

Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA. 2020;323(18):1843-4. https://doi.org/10.1001/jama.2020.3786 PMid:32159775

Zhang JC, Wang SB, Xue YD. Fecal specimen diagnosis 2019 novel coronavirus-infected pneumonia. J Med Virol. 2020;92:680-2. https://doi.org/10.1002/jmv.25742

World Health Organization. Coronavirus Disease (COVID-19) Outbreak Situation. Geneva: World Health Organization; 2020. Available from: http://www.covid19.who.int. [Last accessed on 2020 May 01].

Xiao F, Tang M, Zheng X, Liu Y, Li X, Shan H. Evidence for gastrointestinal infection of SARS-CoV-2. Gastroenterology. 2020;158(6):1831-3.e3. https://doi.org/10.1053/j. gastro.2020.02.055 PMid:32142773

Pan L, Mu MI, Yang P, Sun Y, Wang R, Yan J, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115(5):766-73. https://doi. org/10.14309/ajg.0000000000000620 PMid:32287140

Jin X, Lian J, Hu J, Gao J, Zheng L, Zhang Y, et al. Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms. Gut. 2020;69(6):1002-9. PMid:32213556

Song Y, Liu P, Shi XL, Chu YL, Zhang J, Xia J, et al. SARS-CoV-2 induced diarrhoea as onset symptom in patient with COVID-19. Gut. 2020;69(6):1143-4. https://doi.org/10.1136/ gutjnl-2020-320891 PMid:32139552

Lin L, Jiang X, Zhang Z, Huang S, Zhang Z, Fanf Z. Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection. Gut. 2020;69(6):997-1001. https://doi.org/10.1136/ gutjnl-2020-321013 PMid:32241899

Agarwal A, Chen A, Ravindran N, To C, Thuluvath PJ. Gastrointestinal and liver manifestations of COVID-19. J Clin Exp Hepatol. 2020;10(3):263-5. PMid:32405183

Gu J, Han B, Wang J. COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology. 2020;158(6):1518-9. https://doi.org/10.1053/j. gastro.2020.02.054 PMid:32142785

Hashimoto T, Perlot T, Rehman A, Trichereau J, Ishiguro H, Paolino M, et al. ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation. Nature. 2012;487(7408):477-81. https://doi.org/10.1038/nature11228 PMid:22837003

Wu Y, Guo C, Tang L, Hong Z, Zhou Dong X, et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterol Hepatol. 2020;5(5):434-5. https://doi.org/10.1016/ s2468-1253(20)30083-2 PMid:32199469