Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2021; 27(24): 3502-3515
Published online Jun 28, 2021. doi: 10.3748/wjg.v27.i24.3502
COVID-19 and its effects on the digestive system
Ting-Ting Cao, Gu-Qin Zhang, Emily Pellegrini, Qiu Zhao, Jin Li, Lin-jie Luo, Hua-Qin Pan
Ting-Ting Cao, Qiu Zhao, Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
Gu-Qin Zhang, Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
Emily Pellegrini, Dascena Inc., Houston, TX 77080, United States
Jin Li, Department of Gastroenterology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong Province, China
Lin-jie Luo, Department of Experimental Radiation Oncology and Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, United States
Hua-Qin Pan, Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
Hua-Qin Pan, Clinical Research Center of Hubei Critical Care Medicine, Wuhan 430071, Hubei Province, China
Author contributions: Pan HQ contributed to the conceptions and supervision; Cao TT and Zhang GQ reviewed the literature and drafted the manuscript; Pellegrini E, Luo LJ, Zhao Q, Li J, and Pan HQ checked and revised the manuscript; all authors contributed to the conception and design of the review and approved the final manuscript for submission; Cao TT and Zhang GQ contributed equally to this article; Luo LJ and Pan HQ are senior co-corresponding authors.
Conflict-of-interest statement: All authors who have affiliations with Zhongnan Hospital of Wuhan University declare that they do not have any competing interests. All authors who have affiliations listed with Dascena (Houston, TX, United States) are employees or contractors of Dascena.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hua-Qin Pan, MD, PhD, Associate Chief Physician, Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, No. 169 Eastlake Road, Wuchang District, Wuhan 430071, Hubei Province, China. phq2012@whu.edu.cn
Received: February 28, 2021
Peer-review started: February 28, 2021
First decision: April 5, 2021
Revised: April 16, 2021
Accepted: May 25, 2021
Article in press: May 25, 2021
Published online: June 28, 2021
Processing time: 116 Days and 19.8 Hours
Abstract

Coronavirus disease 2019 (COVID-19) is caused by infection of the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with typical respiratory symptoms. SARS-CoV-2 invades not only the respiratory system, but also other organs expressing the cell surface receptor angiotensin converting enzyme 2. In particular, the digestive system is a susceptible target of SARS-CoV-2. Gastrointestinal symptoms of COVID-19 include anorexia, nausea, vomiting, diarrhea, abdominal pain, and liver damage. Patients with digestive damage have a greater chance of progressing to severe or critical illness, a poorer prognosis, and a higher risk of death. This paper aims to summarize the digestive system symptoms of COVID-19 and discuss fecal-oral contagion of SARS-CoV-2. It also describes the characteristics of inflammatory bowel disease patients with SARS-CoV-2 infection and discusses precautions for preventing SARS-CoV-2 infection during gastrointestinal endoscopy procedures. Improved attention to digestive system abnormalities and gastrointestinal symptoms of COVID-19 patients may aid health care providers in the process of clinical diagnosis, treatment, and epidemic prevention and control.

Keywords: COVID-19; Digestive system; Liver function; Mechanisms; Inflammatory bowel disease; Endoscopy

Core Tip: Coronavirus infections can cause a series of digestive diseases and may also be accompanied by digestive manifestations. Furthermore, the potential mechanisms of coronavirus disease 2019 (COVID-19) on the digestive system, the fecal-oral contagion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the characteristics of inflammatory bowel disease patients with SARS-CoV-2 infection, and the management during gastrointestinal endoscopy procedures are also discussed. This review provides a new perspective to clinicians for the prevention and treatment of COVID-19.