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Diarrhea due to SARS-CoV-2-Related Exocrine Pancreatic Insufficiency
Harish K Patel1,2, Jasbir Makker1,2, Ahemd Alemam1
1Division of Gastroenterology, BronxCare Hospital Center a Clinical Affiliate of Mt Sinai Health Systems and Academic Affiliate of Icahn School of Medicine, Bronx, NY 10457, USA.
Abstract:
Gastrointestinal symptoms, especially diarrhea, are common with novel coronavirus SARS-CoV-2 infection. Angiotensin-converting enzyme-2 (ACE-2) receptors are heavily expressed in enterocytes and serve as entry receptors for SARS-CoV-2. ACE-2 receptors may also be responsible for pancreatic injury in patients infected with SARS-CoV-2. Diarrhea associated with SARS-CoV-2 is usually believed to be due to viral invasion of enterocytes. However, exocrine pancreatic insufficiency resulting from SARS-CoV-2 is another plausible mechanism leading to diarrhea in such patients. We present a case series of three SARS-CoV-2-infected patients with predominant respiratory symptoms at presentation who developed diarrhea, and further fecal analysis revealed exocrine pancreatic insufficiency as the underlying mechanism.
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