What GI Physicians Need to Know During COVID-19 Pandemic

Area of Science:

• Gastroenterology and Hepatology
• Infectious Diseases
• Virology

Background:

• COVID-19, caused by SARS-CoV-2, is a global pandemic with significant health impacts.
• While primarily respiratory, SARS-CoV-2 affects other organs, including the GI tract and liver, due to ACE-2 receptor presence.
• GI symptoms and liver enzyme abnormalities are common in COVID-19 patients.

Purpose of the Study:

• To review the gastrointestinal and liver manifestations of COVID-19.
• To discuss the correlation between GI/liver involvement and disease severity.
• To provide recommendations for GI physicians based on current evidence.

Main Methods:

• Literature review of studies on COVID-19 and its effects on the GI system and liver.
• Analysis of reported GI symptoms, stool viral RNA detection, and liver enzyme elevations.
• Consideration of confounding factors and impact on patients with pre-existing liver disease.

Main Results:

• GI symptoms like anorexia, nausea, vomiting, and diarrhea are prevalent in COVID-19.
• SARS-CoV-2 RNA is detectable in stool samples of a significant portion of patients.
• Elevated liver enzymes are observed in many patients, though often mild and multifactorial.
• Patients with pre-existing liver disease experience more severe COVID-19 and higher mortality.

Conclusions:

• Gastrointestinal and liver involvement are significant aspects of COVID-19, potentially indicating disease severity.
• Further research is needed for optimal management strategies for GI and liver manifestations of COVID-19.
• Physicians should be aware of these extra-pulmonary effects, especially in vulnerable populations.