Coronavirus disease 2019 (COVID-19) and gastrointestinal system

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Rachaneeporn Chueansuwan


Introduction Currently, Coronavirus Disease 2019 (COVID-19) is spreading widely. As of April
2020, more than 2,000,000 people were infected and more than 130,000 deaths in over 200
countries around the world. The morbidity and mortality associated with COVID-19 exceeds
previous coronavirus infection outbreaks including SARS (8,098 infections, 774 deaths) and MERS
(2,458 infections, 848 deaths1
. An initial analysis of 72,314 cases from China revealed that an
about 81% of infections are characterized as mild, 14% are severe, and 5% are critical, with
an overall fatality rate of 2.3%2
. The same study also reported that in addition to symptoms
and contract through the respiratory system, COVID-19 patients can have gastrointestinal and
liver symptoms, as well as to be able to contract through contaminated feces into the mouth.
Therefore, in addition to symptoms and contact through the respiratory system, COVID-19
patients can also have gastrointestinal and liver symptoms, as well as to be able to contact
through contaminated feces into the mouth. In this review article, we summarized the published
literatures to date concerning gastrointestinal manifestations of COVID-19 infection.
Objective To review and summarized the published literatures to date concerning different
aspects of COVID-19 infection including gastrointestinal manifestations the role of fecal–oral
transmission; and prevention/control infection in the digestive endoscopy room.
Method Review and summarize the published literatures to date from PubMed, Ovid, medRxiv
Data sources up to 20 April 2020
Conclusion SARS-CoV-2 is a serious threat to human health worldwide due to its strong
human-to-human transmission ability. In the early days of the disease outbreak, medical staff
focused their main attention on screening for respiratory symptoms. However, as the disease
progresses and the disease understanding unfolds, digestive symptoms related to COVID-19
have also been identified. A recent case series in China has confirmed that SARS-CoV-2 nucleic
acid which has turned negative in throat swabs can still be detected in the feces. It is predictive
and sensible to take early steps to prevent fecal–oral transmission both in the hospital and in
the community. More importantly, efforts should be made to formulate the clinical protocols
and develop antiviral drugs targeting the digestive system in the future.


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