Gastrointestinal Complications of Coronavirus Disease (Covid-19)

Abstract

Background: It is currently understood that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) directly enters target cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. Accordingly, tissues with high expression levels of ACE2 are more susceptible to infection, including pulmonary alveolar epithelial cells, small intestine enterocytes, cholangiocytes, and vascular endothelial cells. Considering the atypical manifestations of COVID-19 and the challenges of early diagnosis, this review addresses the possible gastrointestinal complications of the disease. Method: The phrase “Gastrointestinal complication of COVID” was searched in the PubMed, Medline, and SciELO databases. Due to the heterogeneity of the studies included in the present review, a narrative synthesis of the available qualitative data was performed. Result: The literature search retrieved 28 articles, primarily case reports and case series, for the qualitative analysis of gastrointestinal complications of COVID-19, in addition to two retrospective cohort and one case-control. The studies focused on hemorrhagic, thrombotic, ischemic, and perforation complications, in addition to acute pancreatitis and pneumatosis intestinalis. Conclusion: There is a straight relationship between high expression levels of ACE2 in the gastrointestinal tract and its greater susceptibility to direct infection by SARS-CoV-2. So, it is important to consider the gastrointestinal infection manifestations for early diagnosis and treatment trying to avoid more serious complications and death.

Peritoneal effusion as unusual complication post COVID 19 infection

“…The digestive manifestation can appear in the absence of respiratory symptoms when there are high expression levels of angiotensin-converting enzyme 2 (ACE2) receptor in the intestines and peritoneum [ 13 ]. Gastrointestinal symptoms often misdiagnosed because they appear in the early stages of the disease and are self-limiting, that making it difficult to link them to a COVID-19 diagnosis [ 14 ]. In our paper, we showed a rarer manifestation of COVID19, where it caused the peritoneal effusion without any other digestive symptoms.…”

Results of Surgical Treatment of Colorectal Cancer, Elective and Emergency, in Patients With Covid-19

“…Other gastrointestinal symptoms, such as vomiting, diarrhea, and abdominal pain simulating inflammatory acute abdomen, have been described with COVID-19 and may occur before or even in the absence of respiratory symptoms 9 , 10 , 11 . It was observed that the patient in case 1 presented outputs of up to 4 L daily, which may be related to the diarrhea caused by SARS-COV-2.…”