Journal
TECHNIQUES AND INNOVATIONS IN GASTROINTESTINAL ENDOSCOPY
Volume 23, Issue 2, Pages 179-189Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.tige.2021.01.006
Keywords
COVID-19; Liver injury; Gastrointestinal; Symptoms; Digestive; Hepatitis; Diarrhea; Most current article
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SARS-CoV-2, responsible for COVID-19, shows a wide clinical spectrum with respiratory tract involvement being predominant, but gastrointestinal manifestations are also present possibly due to abundant ACE2 expression in the digestive tract.
SARS-CoV-2 is the virus responsible for COVID-19, whose clinical spectrum ranges widely, both in terms of severity and multi-organicity. SARS-CoV-2 mainly involves the respiratory tract, causing from a flulike syndrome to interstitial pneumonia and acute respiratory distress syndrome. Although its entry receptor, angiotensin-converting-enzyme 2, is typically expressed in epithelial cells of the airways, extra-pulmonary involvement has been consistently demonstrated since the beginning of the outbreak. Gastrointestinal manifestations in COVID-19 may be explained by the abundant expression of ACE2 in the digestive tract. Moreover, not only COVID-19 patients often present with GI symptoms (diarrhea, nausea/vomiting, abdominal pain) and liver tests abnormalities, but there are also data showing active viral replication in the GI tract and possible fecal-oral transmission. Aim of this review is to summarize the evidence regarding prevalence and clinical significance of GI involvement and liver abnormalities in patients with COVID-19, providing the reader with evidence-based recommendations on the management of these conditions.
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