Published online Feb 6, 2022. doi: 10.12998/wjcc.v10.i4.1140
Peer-review started: May 14, 2021
First decision: June 2, 2021
Revised: June 28, 2021
Accepted: December 23, 2021
Article in press: December 23, 2021
Published online: February 6, 2022
Processing time: 254 Days and 21.5 Hours
Coronavirus disease 2019 (COVID-19) has caused a pandemic that affected all countries with nearly 270 million patients and 5 million deaths, as of as of December, 2021. The severe acute respiratory syndrome coronavirus 2 virus targets the receptor, angiotensin-converting enzyme 2, which is frequently found in human intestinal epithelial cells, bile duct epithelial cells, and liver cells, and all gastrointestinal system organs are affected by COVID-19 infection. The aim of this study is to review the gastrointestinal manifestations and liver damage of COVID-19 infection and investigate the severe COVID-19 infection risk in patients that have chronic gastrointestinal disease, along with current treatment guidelines. A literature search was conducted on electronic databases of PubMed, Scopus, and Cochran Library, consisting of COVID-19, liver injury, gastrointestinal system findings, and treatment. Liver and intestinal involvements are the most common manifestations. Diarrhea, anorexia, nausea/vomiting, abdominal pain are the most frequent symptoms seen in intestinal involvement. Mild hepatitis occurs with elevated levels of transaminases. Gastrointestinal involvement is associated with long hospital stay, severity of the disease, and intensive care unit necessity. Treatments and follow-up of patients with inflammatory bowel diseases, cirrhosis, hepatocellular carcinoma, or liver transplant have been negatively affected during the pandemic. Patients with cirrhosis, hepatocellular carcinoma, auto-immune diseases, or liver transplantation may have a greater risk for severe COVID-19. Diagnostic or therapeutic procedures should be restricted with specific conditions. Telemedicine should be used in non-urgent periodic patient follow up. COVID-19 treatment should not be delayed in patients at the risk group. COVID-19 vaccination should be prioritized in this group.
Core Tip: Coronavirus disease 2019 is a pandemic viral infection. The virus binds to the angiotensin-converting enzyme 2 receptor, therefore all tissues and systems are affected by the infection. This review highlighted pathogenesis, clinical and laboratory features of gastrointestinal manifestations and liver injury. Change of gut microbiota was also discussed in this study. Furthermore, risk situations, treatment, and the follow-up of chronic liver diseases, irritable bowel syndrome, and digestive system cancers during the pandemic period with recommendations were discussed.