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Gastrointestinal manifestations in COVID-19
Jayani C Kariyawasam1, Umesh Jayarajah2, Rishdha Riza3
1Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka.
Gastrointestinal (GI) symptoms affect many with COVID-19, ranging from mild issues like diarrhea to severe abdominal conditions. Understanding these GI manifestations is crucial for diagnosis and management of this viral respiratory infection.
Area of Science:
- Gastroenterology and Virology
- Infectious Diseases
- Internal Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is a global respiratory viral pandemic.
- Previous coronaviruses (SARS-CoV-1, MERS-CoV) have shown gastrointestinal (GI) involvement.
- GI manifestations in COVID-19 patients range from 11.4% to 61.1%.
Purpose of the Study:
- To review the significant GI manifestations of COVID-19.
- To discuss the potential pathophysiological mechanisms behind these symptoms.
- To outline diagnostic and management strategies for GI complications in COVID-19.
Main Methods:
- Review of existing literature on COVID-19 and its gastrointestinal effects.
- Analysis of reported GI symptoms, their prevalence, and severity.
- Examination of underlying mechanisms, including direct viral injury and immune response.
Main Results:
- Common GI symptoms include anorexia, diarrhea, nausea, vomiting, and abdominal pain.
- A subset of patients present with acute abdomen conditions (e.g., pancreatitis, appendicitis, bowel obstruction).
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detected throughout the alimentary canal.
Conclusions:
- GI tract involvement in COVID-19 can result from direct viral damage or inflammation.
- Potential consequences include malabsorption, altered gut secretions, and enteric nervous system activation.
- Management primarily involves supportive care, with surgery or endoscopy needed for acute abdominal emergencies and bleeding.
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