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Published on: September 10, 2021
Gastrointestinal manifestations of coronavirus disease 2019
Tejas Joshi1,2, Aijaz Ahmed3, George Cholankeril1,2
1Liver Center, Division of Abdominal Transplantation, Michael E DeBakey Department of General Surgery.
Purpose Of Review:
The ubiquitous expression of angiotensin-converting enzyme-2 receptors and its significance as the origin of viral entry have assisted in comprehending the pathophysiology of extrapulmonary manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, we focus on the clinical significance of gastrointestinal manifestations.
Recent Findings:
The global pandemic, a result of the widespread implications of SARS-CoV-2, remains a significant burden to current healthcare systems. Fever, dyspnea, and tussive symptoms have primarily been recognized as the most common presenting signs/symptoms. During the past one year our scope of practice has transcended beyond the management of the respiratory system to incorporate other varying systemic manifestations such as anorexia, nausea, vomiting, diarrhea, and abdominal pain. The outcomes reported by recent studies suggest an association between the presence of gastrointestinal symptoms and important clinical factors such as delay in presentation, disease severity, and mortality.
Summary:
We provide a summarization of the most recent in-depth investigations of coronavirus disease 2019 with gastrointestinal manifestations and their conclusions. Although the pathophysiology remains an area of evolving interest, a better understanding of this disease process may allow for early recognition, efficient triage, and improved prognostication for those presenting with gastrointestinal manifestations of SARS-CoV-2.
Insights
Gastrointestinal symptoms in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are linked to increased disease severity and mortality. Early recognition of these symptoms is crucial for improved patient outcomes.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Virology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a global pandemic.
- Angiotensin-converting enzyme-2 (ACE2) receptors, crucial for viral entry, are widely expressed, explaining extrapulmonary manifestations.
- Gastrointestinal (GI) symptoms are increasingly recognized beyond respiratory symptoms in COVID-19 patients.
Purpose of the Study:
- To review the clinical significance of gastrointestinal manifestations in COVID-19.
- To summarize recent investigations on GI symptoms associated with SARS-CoV-2 infection.
- To highlight the importance of understanding GI involvement for patient management.
Main Methods:
- Literature review of recent studies on COVID-19 with gastrointestinal manifestations.
- Analysis of the pathophysiology and clinical significance of GI symptoms.
- Summarization of current understanding and conclusions from investigations.
Main Results:
- Gastrointestinal symptoms like anorexia, nausea, vomiting, diarrhea, and abdominal pain are common in COVID-19.
- Studies suggest a correlation between GI symptoms and delayed presentation, increased disease severity, and higher mortality.
- The presence of ACE2 receptors in the GI tract contributes to viral entry and subsequent manifestations.
Conclusions:
- Gastrointestinal manifestations of SARS-CoV-2 are clinically significant and impact patient outcomes.
- Understanding the pathophysiology of GI involvement can aid in early recognition and triage.
- Improved prognostication is possible with a better grasp of the link between GI symptoms and COVID-19 severity.
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