Involvement of the digestive system in covid-19. A review

Gastroenterol Hepatol. 2020 Oct;43(8):464-471. doi: 10.1016/j.gastrohep.2020.06.004. Epub 2020 Jun 19.
[Article in English, Spanish]

Abstract

The SARS-CoV-2 pandemic is leading to high mortality and a global health crisis. The primary involvement is respiratory; however, the virus can also affect other organs, such as the gastrointestinal tract and liver. The most common symptoms are anorexia and diarrhea. In about half of the cases, viral RNA could be detected in the stool, which is another line of transmission and diagnosis. covid19 has a worse prognosis in patients with comorbidities, although there is not enough evidence in case of previous digestive diseases. Digestive endoscopies may give rise to aerosols, which make them techniques with a high risk of infection. Experts and scientific organizations worldwide have developed guidelines for preventive measures. The available evidence on gastrointestinal and hepatic involvement, the impact on patients with previous digestive diseases and operating guidelines for Endoscopy Units during the pandemic are reviewed.

Keywords: Aparato digestivo; Digestive system; Endoscopia digestiva; Gastrointestinal endoscopy; Hígado; Liver; Pandemia; Pandemics; Review; Revisión; SARS-CoV-2; covid-19.

Publication types

  • Systematic Review

MeSH terms

  • Aerosols
  • Angiotensin-Converting Enzyme 2
  • Anorexia / etiology
  • Antiviral Agents / adverse effects
  • Betacoronavirus / isolation & purification
  • Betacoronavirus / pathogenicity*
  • Betacoronavirus / physiology
  • COVID-19
  • COVID-19 Drug Treatment
  • Cohort Studies
  • Coronavirus Infections / complications*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / transmission
  • Diarrhea / etiology
  • Digestive System / virology*
  • Digestive System Diseases / etiology*
  • Digestive System Diseases / virology
  • Endoscopy, Digestive System / adverse effects
  • Feces / virology
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Intestines / chemistry
  • Intestines / virology
  • Liver Diseases / etiology
  • Multicenter Studies as Topic
  • Pandemics* / prevention & control
  • Peptidyl-Dipeptidase A / analysis
  • Peptidyl-Dipeptidase A / physiology
  • Personal Protective Equipment
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / drug therapy
  • Pneumonia, Viral / prevention & control
  • Pneumonia, Viral / transmission
  • Receptors, Virus / analysis
  • Receptors, Virus / physiology
  • Risk
  • SARS-CoV-2
  • Universal Precautions

Substances

  • Aerosols
  • Antiviral Agents
  • Immunosuppressive Agents
  • Receptors, Virus
  • Peptidyl-Dipeptidase A
  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2