Digestive manifestations in COVID-19: Prevalence and prognostic impact.

Elloumi Kharrat, Hanen; Ghanem, Mohamed; Bouchabou, B; Bouali, Riadh; Elloumi, Héla

BACKGROUND Since its declaration in december 2019, a novel coronavirus, the SARS-CoV-2 was rapidly responsible for a major pandemic. COVID-19 is mainly manifested by respiratory symptoms,however, digestive manifestations have been reported, raising the hypothesis of the viral digestive tropism. AIMS Specify the digestive manifestations due to the SARS-CoV-2, and their impact on the disease prognosis and describe the COVID-19 effect in patients with underlying digestive disease. METHODS Ageneral review of the medical literature was conducted via Medline® database, through various combinations of the following keywords :SARS-CoV-2, COVID-19, gastrointestinal tract, digestive system, inflammatory bowel diseases, liver, liver injury, chronic liver disease, neoplasms. The most relevant articles were selected. RESULTS The SARS-CoV-2 tropism for the digestive tract has been confirmed by the identification of the enterocyte as a target cell of the virus. Viral particles and RNA detection in stool of infected patients has raised the potential for feco-oral transmission of the virus. Gastrointestinal manifestations were frequent and may even be revealing or isolated. Diarrhea was the most characteristic symptom. Frequent liver involvement is associated with a more severe form of the disease. Patients with digestive cancer and chronic liver disease are at risk for a severe form of SARS-CoV-2 infection. CONCLUSION The clinician is required to know this type of manifestations in order to limit the delay in diagnosis and to better assess the prognosis.