Intestines: mucosal damage in oesophagus with multiple round herpetic erosions and ulcers and numerous infiltrating plasma cells and lymphocytes as well as interstitial oedema in the lamina propria of the stomach, duodenum and rectum 21, 22 Intestines: no obvious pathological changes reported Intestines: no obvious pathological changes/non-specific changes depletion of mucosal lymphoid tissue 20 Stool RT-PCR positive rate from the time of diagnosis 8, 10–22 Herein we outline the important GI manifestations of COVID-19 and discuss the possible mechanisms and aspects relating to their diagnosis and management.īat → civets 10 China, Guangdong Province 9 Although fever and respiratory symptoms predominate in coronavirus infections, gastrointestinal (GI) manifestations were seen in SARS-CoV-1, MERS-CoV and SARS-CoV-2 patients (Table 1). 8 SARS-CoV-2 has 70% and 40% genetic sequence similarity with SARS-CoV-1 and MERS-CoV. 5–7 Outbreaks of SARS-CoV-1 and MERS-CoV infections occurred in 20, respectively. Human coronavirus OC43 (HCoV-OC43), human coronavirus HKU1 (HCoV-HKU1), human coronavirus 229E (HCoV-229E) and human coronavirus NL63 (HCoV-NL63) cause mild disease, while the severe acute respiratory syndrome coronavirus (SARS-CoV-1), Middle East respiratory syndrome–related coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may potentially cause severe disease. 3 Human coronaviruses were discovered in the 1960s 4 and presently seven strains cause disease.
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2 The earliest record of coronavirus infections among animals was in the late 1920s, where acute respiratory infections occurred in domesticated chickens in North America. 1 Several vaccines have been developed to control the pandemic. It is currently a pandemic and as of 26 December 2020 there have been >79 million cases worldwide and >1.7 million deaths. However, a minority may require surgical or endoscopic treatment for acute abdomen and GI bleeding.Ĭoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Supportive and symptomatic care is the mainstay of therapy. Involvement of the GI tract may be due to direct viral injury and/or an inflammatory immune response and may lead to malabsorption, an imbalance in intestinal secretions and gut mucosal integrity and activation of the enteric nervous system. Severe acute respiratory syndrome coronavirus 2 RNA has been found in biopsies from all parts of the alimentary canal. A minority of patients present with an acute abdomen with aetiologies such as acute pancreatitis, acute appendicitis, intestinal obstruction, bowel ischaemia, haemoperitoneum or abdominal compartment syndrome.
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The majority of COVID-19-associated GI symptoms are mild and self-limiting and include anorexia, diarrhoea, nausea, vomiting and abdominal pain/discomfort. GI manifestations are reported in 11.4–61.1% of individuals with COVID-19, with variable onset and severity. In this review we outline the important GI manifestations of COVID-19 and discuss the possible underlying pathophysiological mechanisms and their diagnosis and management. Previous studies reported that severe acute respiratory syndrome coronavirus 1 and Middle East respiratory syndrome–related coronavirus infections may affect the gastrointestinal (GI) system. Coronavirus disease 2019 (COVID-19), a respiratory viral infection, has affected more than 78 million individuals worldwide as of the end of December 2020.