Remarkable gastrointestinal and liver manifestations of COVID-19: A clinical and radiologic overview

Abstract

The coronavirus disease 2019 (COVID-19) raging around the world still has not been effectively controlled in most countries and regions. As a severe acute respiratory syndrome coronavirus, in addition to the most common infectious pneumonia, it can also cause digestive system disease such as diarrhea, nausea, vomiting, liver function damage, etc. In medical imaging, it manifests as thickening of the intestinal wall, intestinal perforation, pneumoperitoneum, ascites and decreased liver density. Angiotensin-converting enzyme 2 has great significance in COVID-19-related digestive tract diseases. In this review, we summarized the data on the clinical and imaging manifestations of gastrointestinal and liver injury caused by COVID-19 so far and explored its possible pathogenesis.

Keywords: COVID-19; SARS-CoV-2; Gastrointestinal; Liver; Radiologic manifestations; Angiotensin-converting enzyme 2; Computed tomography

Core Tip: There are few reviews on the clinical and radiologic manifestations of gastrointestinal and liver in coronavirus disease 2019 (COVID-19). Here, we review the significant information on the management of patients with COVID-19 and the mechanism of how angiotensin-converting enzyme 2, the key factor of COVID-19 infection, relates to severe acute respiratory syndrome coronavirus 2 with digestive tract symptoms. The potential mechanism of fatty change of the liver is discussed in this review as well.