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Published on: September 10, 2021
Coronavirus disease 2019 gastrointestinal and liver manifestations in adults: A review
Apichet Sirinawasatien1, Tanyaporn Chantarojanasiri1, Sirina Ekpanyapong1
1Division of Gastroenterology, Department of Medicine, Rajavithi Hospital, College of Medicine Rungsit University Bangkok Thailand.
Insights
Coronavirus disease 2019 (COVID-19) impacts the gastrointestinal system, causing liver issues and other symptoms. Disease severity correlates with gastrointestinal injury, managed by supportive care.
Area of Science:
- Gastroenterology
- Virology
- Hepatology
Background:
- Coronavirus disease 2019 (COVID-19) presents significant global health and economic challenges.
- Beyond respiratory symptoms, COVID-19 affects multiple organ systems, including the gastrointestinal tract and liver.
- Direct viral invasion of gastrointestinal tissues and vasculature contributes to diverse clinical manifestations.
Purpose of the Study:
- To investigate the gastrointestinal and hepatic manifestations of COVID-19.
- To explore the correlation between gastrointestinal injury severity and overall disease severity.
- To assess the implications of COVID-19 on patients with pre-existing liver conditions.
Main Methods:
- Review of evidence on COVID-19's systemic effects, focusing on gastrointestinal and liver involvement.
- Analysis of reported gastrointestinal symptoms (diarrhea, nausea, bleeding) and liver function test abnormalities.
- Examination of the impact of coexisting liver disease on COVID-19 outcomes.
Main Results:
- COVID-19 infection can lead to direct gastrointestinal tissue damage, resulting in symptoms like diarrhea and nausea.
- The extent of gastrointestinal injury, particularly liver involvement, is linked to the severity of COVID-19.
- Patients with pre-existing liver disease face increased risks of liver decompensation and mortality when infected with SARS-CoV-2.
Conclusions:
- Gastrointestinal and liver complications are significant aspects of COVID-19, requiring supportive management.
- Endoscopic procedures necessitate stringent protective measures due to the presence of SARS-CoV-2 in gastrointestinal contents.
- Understanding these effects is crucial for comprehensive patient care and infection control during the pandemic.
Abstract:
Coronavirus disease 2019 (COVID-19) is an important health problem that has a serious adverse impact on the global economy and healthcare systems. The virus is not only involved in the respiratory system, but also causes other systemic effects as well as several gastrointestinal and liver issues. Evidence has shown direct viral invasion into the gastrointestinal tissue and supporting vascular network, causing various manifestations such as diarrhea, nausea, gastrointestinal bleeding, and abnormal liver function tests. The degree of gastrointestinal injury, especially in terms of liver involvement, is correlated with disease severity. There is no specific treatment for gastrointestinal involvement, and the symptoms can be managed with supportive therapy. Moreover, increased liver decompensation and mortality can be found in COVID-19-infected patients with coexisting liver disease. As the virus can be identified in gastrointestinal contents, endoscopic procedures during the pandemic should be carefully selected and proper protection strategies should be encouraged to prevent viral transmission.
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