The Spectrum of Digestive Tract Histopathologic Findings in the Setting of Severe Acute Respiratory Syndrome Coronavirus-2 Infection: What Pathologists Need to Know

Abstract

Although the novel severe acute respiratory syndrome coronavirus-2 is known primarily to affect the respiratory system, current evidence supports its capability to infect and induce gastrointestinal tract injury. Data describing the histopathologic alterations of the digestive system in patients infected with severe acute respiratory syndrome coronavirus-2 are becoming more detailed, as the number of studies is increasing and the quality of our insight into the infection and the histopathologic findings is improving. This review highlights the range of pathologic findings that could be observed in gastrointestinal specimens from patients infected with coronavirus disease 2019 and the potential underlying pathogenetic mechanisms of this disease.

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“…[ 20 ] Subsequent reports revealed that ACE2 is significantly expressed in the colonocytes of the colon, the lining enterocytes from the ileum, and the esophageal epithelium. [ 21 ] The discovery of the virus in the GI lumen near its matching receptor provides compelling evidence that COVID-19 can actively replicate, infect, and cause enteric disease, perhaps resulting in fecal transmission. [ 22 ] Moreover, an unexpected finding has also been revealed in that 64% of COVID-19 patients continued to test positive for viral RNA in the feces once the pharyngeal test was showing negative.…”