Gastrointestinal, and hepatic involvement in Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection: A review

Ghoshal, Uday C.; Ghoshal, Ujjala; Dhiman, Radha Krishan

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection has caused a pandemic Coronavirus Disease-19 (COVID-19) that began in Wuhan city, China, in December 2019. Till 14(th) April 19,39,801 people have been affected by this virus 1,20,897 of whom died. Though respiratory symptoms are the typical manifestation of this disease, gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, loss of taste sensation, diarrhea, abdominal pain, and discomfort have been reported. The pooled prevalence of GI symptom is 17.6% (95% confidence interval [CI], 12.3%–24.5%), as indicated in a meta-analysis. A few studies suggested that the presence of GI symptoms is associated with poorer prognosis. The virus is excreted in feces during the acute disease, and even after the nasopharyngeal swab has become negative for viral ribonucleic acid (RNA). Fecal viral excretion may have clinical significance due to possible feco-oral transmission of the infection. 10.5% to 53% of patients with COVID-19, particularly those with severe disease, have been shown to have an elevation of hepatic enzymes through biochemical and clinical jaundice, are uncommon. Knowledge about this disease in general and GI involvement, in particular, is currently evolving.