Gastrointestinal Manifestations of COVID-19: A Review of What We Know
Andrew Groff1, Madison Kavanaugh2, Devyani Ramgobin3
1Penn State College of Medicine, Hershey, PA.
Insights
Coronavirus disease 2019 (COVID-19) affects the gastrointestinal (GI) tract, causing symptoms like diarrhea and nausea. COVID-19 RNA in stool suggests potential fecal-oral transmission, even without respiratory signs.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Hepatology
Background:
- Coronavirus disease 2019 (COVID-19) extends beyond respiratory symptoms, significantly impacting the gastrointestinal (GI) system.
- Understanding diverse organ system involvement is crucial for controlling community transmission of COVID-19.
Purpose of the Study:
- To review the pathophysiology of COVID-19 within the GI tract.
- To investigate the virus's effects on the gut and liver, including fecal-oral transmission potential.
Main Methods:
- Literature review focusing on case studies from China during the COVID-19 surge.
- Analysis of evidence regarding GI pathophysiology, gut/liver effects, and viral presence in stool.
Main Results:
- Gastrointestinal symptoms (anorexia, nausea, vomiting, diarrhea, abdominal pain) frequently co-occur with respiratory symptoms in COVID-19 patients.
- Elevated liver enzymes (ALT, AST, GGT) indicate acute hepatocellular injury in some COVID-19 cases.
- Detection of COVID-19 RNA in stool samples supports the hypothesis of fecal-oral transmission.
Conclusions:
- Gastrointestinal symptoms can be primary indicators of COVID-19 infection, even in the absence of respiratory manifestations.
- The potential for fecal-oral transmission necessitates considering COVID-19 in patients presenting with isolated GI symptoms.
Abstract:
Background: The coronavirus disease 2019 (COVID-19) is not just a disease of the respiratory system. The virus can affect the gastrointestinal (GI) tract as well. Recognizing the various manifestations in every organ system is important because these manifestations can contribute to community-based transmission. Methods: We outline the evidence of the pathophysiology of COVID-19 in the GI tract, the effects of the virus on the gut and liver, the presence of the virus in stool samples, and the potential for fecal-oral transmission of COVID-19. Most of the literature sources used in this paper are case studies from China following the surge of COVID-19 infection. Results: In patients with COVID-19, GI symptoms such as anorexia, nausea, vomiting, diarrhea, and abdominal pain have presented in conjunction with respiratory symptoms such as fever, shortness of breath, and cough. Evidence also shows acute hepatocellular injury, indicated by elevated liver enzymes such as alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase. Fecal-oral transmission of COVID-19 is suspected because of the presence of COVID-19 RNA in stool samples of COVID-19-positive patients. Conclusion: Even without the presence of respiratory symptoms, several GI symptoms are associated with COVID-19 infection, as well as possible fecal-oral transmission. Therefore, COVID-19 infection should be considered for patients presenting with primarily GI symptoms.
More Related Videos
03:48Author Spotlight: Exploring the Mysteries of Sichuan's Herbal Medicine in Chinese Medicine Research
Published on: March 1, 2024
07:59Adapting Gastrointestinal Organoids for Pathogen Infection and Single Cell Sequencing under Biosafety Level 3 BSL-3 Conditions
Published on: September 10, 2021
Related Concept Videos
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...