Current understanding of the impact of COVID-19 on gastrointestinal disease: Challenges and openings

World J Gastroenterol. 2021 Feb 14;27(6):449-469. doi: 10.3748/wjg.v27.i6.449.


The novel coronavirus disease-2019 (COVID-19) is caused by a positive-sense single-stranded RNA virus which belongs to the Coronaviridae family. In March 2019 the World Health Organization declared that COVID-19 was a pandemic. COVID-19 patients typically have a fever, dry cough, dyspnea, fatigue, and anosmia. Some patients also report gastrointestinal (GI) symptoms, including diarrhea, nausea, vomiting, and abdominal pain, as well as liver enzyme abnormalities. Surprisingly, many studies have found severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral RNA in rectal swabs and stool specimens of asymptomatic COVID-19 patients. In addition, viral receptor angiotensin-converting enzyme 2 and transmembrane protease serine-type 2, were also found to be highly expressed in gastrointestinal epithelial cells of the intestinal mucosa. Furthermore, SARS-CoV-2 can dynamically infect and replicate in both GI and liver cells. Taken together these results indicate that the GI tract is a potential target of SARS-CoV-2. Therefore, the present review summarizes the vital information available to date on COVID-19 and its impact on GI aspects.

Keywords: COVID-19; Diagnosis; Gastrointestinal symptoms; Recommendation; SARS-CoV-2; Therapeutics.

Publication types

  • Review

MeSH terms

  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • Endoscopy, Gastrointestinal
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / virology*
  • Host-Pathogen Interactions
  • Humans
  • Liver Diseases / complications
  • Liver Diseases / therapy*
  • SARS-CoV-2 / physiology*