Authors: Ozgur Karcioglu, Goksu Afacan, Bilgen Ozkaya, Mandana Hosseinzadeh, Ebru Yilmaz, Mehmet Ozel, Selman Yeniocak.
Aim (Background): The gastrointestinal system (GIS) is important in diagnostic procedures screening for COVID-19. Nausea/vomiting, diarrhea, abdominal pain, and ageusia are gastrointestinal (GI) symptoms commonly recorded in the pandemic. This review aims to shed light on this important aspect of the course of COVID-19, with a special emphasis on diagnostic opportunities.
Materials and Methods: Currently available literature on the GI manifestations of COVID-19 was identified through searches of the available databases. Data on the characteristics, features, and outcomes associated with GI signs and symptoms, along with diagnostic opportunities and relevant comorbid states [e.g., inflammatory bowel diseases (IBD) and liver failure], were extracted from the manuscripts.
Results: The GIS was shown to be closely interrelated with COVID-19 in several ways. The presence and severity of GI complaints are correlated with the severity of the disease. Those with GI signs and symptoms have higher AST and ALT and coagulopathy. Those with GI signs more commonly have fever; however, they suffer from milder disease. While liver damage is associated with lymphopenia, neutropenia and male sex, it has been observed that AST is associated with mortality in COVID-19 patients. IBD does not pose a high risk for COVID-19.
Conclusion: While RNA positivity in the GIS provides a major diagnostic opportunity, it also represents a dangerous situation for healthcare workers and the public in regard to fecal-oral transmission. The GIS was associated with COVID-19 in patients with chronic disorders such as liver disease and IBD.
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