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Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review.
World J Gastroenterol. 2020 May 21; 26(19):2323-2332.WJ

Abstract

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) is a global pandemic, manifested by an infectious pneumonia. Although patients primarily present with fever, cough and dyspnea, some patients also develop gastrointestinal (GI) and hepatic manifestations. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Liver chemistry abnormalities are common and include elevation of aspartate transferase, alanine transferase, and total bilirubin. Studies have shown that SARS-CoV-2 infects the GI tract via its viral receptor angiotensin converting enzyme II, which is expressed on enterocytes of the ileum and colon. Viral RNA has also been isolated from stool specimens of COVID-19 patients, which raised the concern for fecal-oral transmission in addition to droplet transmission. Although indirect evidence has suggested possible fecal-oral transmission of SARS-CoV-2, more effort is needed to establish the role of the fecal-oral transmission route. Further research will help elucidate the association between patients with underlying GI diseases, such as chronic liver disease and inflammatory bowel disease, and severity of COVID-19. In this review, we summarize the data on GI involvement to date, as well as the impact of COVID-19 on underlying GI diseases.

Authors+Show Affiliations

Department of Internal Medicine, Cleveland Clinic, Akron General, Akron, OH 44307, United States.Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44307, United States.Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH 44307, United States. sandhud@ccf.org.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32476796

Citation

Cha, Ming Han, et al. "Gastrointestinal and Hepatic Manifestations of COVID-19: a Comprehensive Review." World Journal of Gastroenterology, vol. 26, no. 19, 2020, pp. 2323-2332.
Cha MH, Regueiro M, Sandhu DS. Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review. World J Gastroenterol. 2020;26(19):2323-2332.
Cha, M. H., Regueiro, M., & Sandhu, D. S. (2020). Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review. World Journal of Gastroenterology, 26(19), 2323-2332. https://doi.org/10.3748/wjg.v26.i19.2323
Cha MH, Regueiro M, Sandhu DS. Gastrointestinal and Hepatic Manifestations of COVID-19: a Comprehensive Review. World J Gastroenterol. 2020 May 21;26(19):2323-2332. PubMed PMID: 32476796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Gastrointestinal and hepatic manifestations of COVID-19: A comprehensive review. AU - Cha,Ming Han, AU - Regueiro,Miguel, AU - Sandhu,Dalbir S, PY - 2020/04/10/received PY - 2020/04/25/revised PY - 2020/05/16/accepted PY - 2020/6/2/entrez PY - 2020/6/2/pubmed PY - 2020/6/9/medline KW - COVID-19 KW - Diarrhea KW - Gastrointestinal KW - Inflammatory bowel disease KW - Liver KW - SARS-CoV-2 SP - 2323 EP - 2332 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 26 IS - 19 N2 - The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) is a global pandemic, manifested by an infectious pneumonia. Although patients primarily present with fever, cough and dyspnea, some patients also develop gastrointestinal (GI) and hepatic manifestations. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Liver chemistry abnormalities are common and include elevation of aspartate transferase, alanine transferase, and total bilirubin. Studies have shown that SARS-CoV-2 infects the GI tract via its viral receptor angiotensin converting enzyme II, which is expressed on enterocytes of the ileum and colon. Viral RNA has also been isolated from stool specimens of COVID-19 patients, which raised the concern for fecal-oral transmission in addition to droplet transmission. Although indirect evidence has suggested possible fecal-oral transmission of SARS-CoV-2, more effort is needed to establish the role of the fecal-oral transmission route. Further research will help elucidate the association between patients with underlying GI diseases, such as chronic liver disease and inflammatory bowel disease, and severity of COVID-19. In this review, we summarize the data on GI involvement to date, as well as the impact of COVID-19 on underlying GI diseases. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/32476796/Gastrointestinal_and_hepatic_manifestations_of_COVID_19:_A_comprehensive_review_ L2 - https://www.wjgnet.com/1007-9327/full/v26/i19/2323.htm DB - PRIME DP - Unbound Medicine ER -