[COVID-19-associated diarrhea].

Area of Science:

• Gastroenterology
• Infectious Diseases
• Virology

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents with a gastroenterotropic effect, leading to diarrhea in 2-49.5% of COVID-19 cases.
• Diarrhea complicates COVID-19 management by worsening clinical status, hindering diagnostics, and complicating therapy selection.

Purpose of the Study:

• To analyze scientific literature on the pathogenesis, incidence, clinical features, diagnosis, and therapy of diarrhea in COVID-19 patients.

Main Methods:

• A comprehensive literature search was conducted using PubMed, Google Scholar, and eLIBRARY.ru.
• Publications focusing on the pathogenesis, diagnosis, and treatment of diarrhea in COVID-19 patients were analyzed.

Main Results:

• Diarrhea pathogenesis in COVID-19 is multifactorial, involving viral interaction with ACE2 receptors, gastrointestinal inflammation, neurotropic effects, gut microbiota disruption, and organ damage.
• Iatrogenic factors, including drug side effects and opportunistic pathogen activation (e.g., Clostridioides difficile), contribute significantly to COVID-associated diarrhea.
• Diagnostic priorities include fecal analysis for C. difficile toxins, with limited endoscopic procedures during the pandemic.

Conclusions:

• Diarrhea is a frequent and significant clinical manifestation of COVID-19, impacting disease progression.
• "COVID-associated diarrhea" is recognized as an independent clinical entity requiring tailored management strategies.
• Further research into therapeutic approaches and nutritional support is crucial for managing post-COVID-19 diarrheal syndrome.