Digestive manifestations in patients with COVID-19

Authors

DOI:

https://doi.org/10.5281/zenodo.11493394

Keywords:

covid-19, ; hemorrhagic shock, gastrointestinal diseases, sars-cov-2

Abstract

Introduction: COVID-19 is a disease with a wide clinical spectrum, where digestive manifestations can not only accompany, but sometimes precede respiratory symptoms.

Objective: to describe the main digestive manifestations in patients with COVID-19.

Methods: a bibliographic review was carried out on the subject, where 31 articles in English and Spanish were consulted, available in the PubMed, Medline, Lilacs, SciELO databases and in the Google Scholar search engine.

Development: despite the fact that most patients with COVID-19 present predominantly respiratory symptoms, some may present digestive manifestations, which is determined by the affinity of SARS-CoV-2 for the angiotensin-converting enzyme 2 (ACE-2) receptor, present on the cell surface of much of the digestive tract and to a lesser extent at the liver level.

Conclusions: digestive manifestations in patients with COVID-19 are relatively common and could be a clinical presentation of the disease. Gastrointestinal symptoms reported have been diarrhea, nausea, vomiting, anorexia, abdominal pain and in some cases digestive bleeding. The hepatogram revealed a mild, transient elevation of transaminases without clinical relevance. In severe cases, hypoalbuminemia has been described, without any other element of liver failure.

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Author Biographies

Alberto Martínez Sarmiento, Hospital General Provincial Docente “Dr. Antonio Luaces Iraola. Ciego de Ávila.

Máster en Enfermedades Infecciosas. Especialista de Primer y Segundo Grados en Gastroenterología. Especialista de Primer Grado en Medicina General Integral. Profesor Auxiliar. Investigador Agregado. Hospital General Provincial Docente “Dr. Antonio Luaces Iraola. Ciego de Ávila.

Milagros Cárdenas Quintana, Hospital General Provincial Docente “Dr. Antonio Luaces Iraola” de Ciego de Ávila.

Máster en Procederes Diagnósticos en el Primer Nivel de Atención de Salud. Especialista de Primer y Segundo Grados en Gastroenterología. Especialista de Primer Grado en Medicina General Integral. Profesor Asistente. Hospital General Provincial Docente “Dr. Antonio Luaces Iraola” de Ciego de Ávila.

María Lucía Martínez Ruíz, Facultad de Ciencias Médicas “José Assef Yara”

Estudiante de segundo año de la carrera de Medicina. Facultad de Ciencias Médicas “José Assef Yara”.

References

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature [Internet]. 2020 [citado 24 Oct 2021];579:270-73. Disponible en: https://www.nature.com/articles/s41586-020-2012-7.pdf

Sharma A, Ahmad-Farouk I, kumar-Lal S. COVID-19: A review on the novel coronavirus disease evolution, transmission, detection, control and prevention. Viruses [Internet]. 2021 [citado 24 Oct 2021];13(202):[aprox. 25p.]. Disponible en: https://www.mdpi.com/1999-4915/13/2/202/pdf

World Health Organization. WHO Director-General’s remarks at the media briefing on 2019-nCoV on 11 march 2020 [Internet]. 2020 [citado 24 Oct 2021]. [aprox. 3 p.]. Disponible en: https://www.who.int/es/director-general/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet]. 2020 [citado 25 oct 2021];395(10223):497-506. Disponible en: https://doi.org/10.1016/S0140-6736(20)30183-5

Synowiec A, Szczepanski A, Barreto-Duran E, Lie LK, Pyrc K. Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2): a systemic infection. Clin Microbiol Rev [Internet]. 2021 [citado 25 Oct 2021];34(2):e00133-20. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7849242/pdf/CMR.00133-20.pdf

Rahman S, Villagomez-Montero MT, Rowe K, Kirton R, Kunik F. Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence. Expert Rev Clin Pharmacol [Internet]. 2021 [citado 25 Oct 2021];14(5):[aprox. 21 p]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095162/pdf/IERJ_0_1902303.pdf

Groff A, Kavanaugh M, Ramgobin D, McClafferty B, Shekher-Aggarwal C, Golamari R, et al. Gastrointestinal manifestations of COVID-19: A review of what we know. Ochsner J [Internet]. 2021 [citado 27 Oct 2021];21:177–80. Disponible en: http://www.ochsnerjournal.org/content/ochjnl/21/2/177.full.pdf

Zhang Y, Zheng L, Liu L, Zhao M, Xiao J, Zhao Q. Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China. Liver Int [Internet]. 2020 [citado 27 Oct 2021];40(9):2095–2103. Disponible en: https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14455

Su S, Shen J, Zhu L, Qiu Y, He JS, Tan JY, et al. Involvement of digestive system in COVID-19: manifestations, pathology, management and challenges. Ther Adv Gastroenterol [Internet]. 2020 [citado 27 Oct 2021];13:1–12. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303511/pdf/10.1177_1756284820934626.pdf

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA [Internet]. 2020 [citado 27 Oct 2021];323(13):1239-42. Disponible en: https://jamanetwork.com/journals/jama/articlepdf/2762130/jama_wu_2020_vp_200028.pdf

Díaz P LA, Espino EA. Manifestaciones gastrointestinales de pacientes infectados con el nuevo coronavirus SARS-CoV-2. Gastroenterol Latinoam [Internet]. 2020 [citado 27 Oct 2021]; 31(1):35–8. Disponible en: https://gastrolat.org/DOI/PDF/10.46613/gastrolat202001-05.pdf

Infante-Velázquez M. Implicaciones de la infección por el nuevo coronavirus SARS-Cov-2 para

el sistema digestivo. Arch Cub Gastroenterol [Internet]. 2020 [citado 28 Oct 2021];1(2):e38. Disponible en: https://revgastro.sld.cu/index.php/gast/article/download/38/119

Meng XJ, Liang TJ. SARS-CoV-2 infection in the gastrointestinal tract: fecal–oral route of transmission for COVID-19? Gastroenterol [Internet]. 2021 [citado 28 Oct 2021];160(5):1467–74. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790455/pdf/main.pdf

Chen ZR, Liu J, Liao ZG, Zhou J, Peng HW, Gong F, et al. COVID-19 and gastroenteric manifestations. World J Clin Cases [Internet]. 2021 [citado 28 Oct 2021];9(19):4990–97. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283602/pdf/WJCC-9-4990.pdf

Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, et al. First case of 2019 novel coronavirus in the United States. N Engl J Med [Internet]. 2020 [citado 28 Oct 2021];382:929–36. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa2001191

Sanz-Segura P, Arguedas-Lázaro Y, Mostacero-Tapia S, Cabrera-Chaves T, Sebastián-Domingo JJ. Afectación del aparato digestivo en la covid-19. Una revisión sobre el tema. Gastroenterol Hepatol [Internet]. 2020 [citado 29 Oct 2021];43(8):464–71. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303613/pdf/main.pdf

Wong SH, Lui RNS, Sung JJY. Covid-19 and the digestive system. J Gastroenterol Hepatol [Internet]. 2020 [citado 29 Oct 2021];35:744–48. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jgh.15047

Kariyawasam JC, Jayarajah U, Riza R, Abeysuriya V, Seneviratne SL. Gastrointestinal manifestations in COVID-19. Trans R Soc Trop Med Hyg [Internet]. 2021 [citado 29 Oct 2021]: [aprox. 27 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989191/pdf/trab042.pdf

Freire-Alberca GG, Solis-Castro RL, Solis-Castro ME, Alberca RW. Coronavirus disease–2019 and the intestinal tract: An overview. World J Gastroenterol [Internet]. 2021[citado 29 Oct 2021];27(13):1255-66. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015300/pdf/WJG-27-1255.pdf

Cheung KS, Hung IFN, Chan PPY, Lung KC, Tso E, Raymond Liu, et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong Cohort: systematic review and meta-analysis. Gastroenterol [Internet]. 2020 [citado 28 Oct 2021];159:81–95. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015300/pdf/WJG-27-1255.pdf

Ghoshal UC, Ghoshal U, Mathur A, Singh RK, Nath A, Garg A, et al. The spectrum of gastrointestinal symptoms in patients with coronavirus disease-19: Predictors, relationship with disease severity, and outcome. Clin Transl Gastroenterol [Internet]. 2020 [citado 29 Oct 2021];11:[aprox. 9p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7678797/pdf/ct9-11-e00259.pdf

Pan L, Mu M, Yang P, Sun Y, Wang R, Yan J, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol [Internet]. 2020 [citado 30 Oct 2021];115(5):766–73. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172492/pdf/acg-publish_ahead_of_print-10.14309_ajg.0000000000000620.pdf

Chen H, Tong Z, Ma Z, Luo L, Tang Y, Teng Y, et al. Gastrointestinal bleeding, but not other gastrointestinal symptoms, is associated with worse outcomes in COVID-19 patients. Front Med [Internet]. 2021 [citado 30 Oct 2021];8:[aprox. 8p.] Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548414/pdf/fmed-08-759152.pdf

Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int [Internet]. 2020 [citado 30 Oct 2021];40:998–1004. Disponible en: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/liv.14435

Gracia-Ramos AE, Jaquez-Quintana JO, Contreras-Omaña R, Auron M. Liver dysfunction and SARS-CoV-2 infection. World J Gastroenterol [Internet]. 2021 [citado 30 Oct 2021];27(26):3951–70. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8311530/pdf/WJG-27-3951.pdf

Téllez L, Martín Mateos RM. Actualización en COVID-19 y enfermedad hepática. Gastroenterol Hepatol [Internet]. 2020 [citado 1 Nov 2021];43(8):472–80. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332955/pdf/main.pdf

Boeckmans J, Rodrigues RM, Demuyser T, Piérard D, Vanhaecke T, Rogiers V. COVID-19 and drug-induced liver injury: a problem of plenty or a petty point? Arch Toxicol [Internet]. 2020 [citado 1 Nov 2021];94(1):1367–9. Disponible en: https://cris.vub.be/ws/files/79941664/51694828.pdf

Díaz LA, Idalsoaga F, Cannistra M, Candia R, Cabrera D, Barrera F, et al. High prevalence of hepatic steatosis and vascular thrombosis in COVID-19: A systematic review and meta-analysis of autopsy data. World J Gastroenterol [Internet]. 2020 [citado 1 Nov 2021];26(48):7693–7706. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7789052/pdf/WJG-26-7693.pdf

Dawood RM, Salum GM, El-Meguid MA. The impact of COVID-19 on liver injury. Am J Med Sci [Internet]. 2021 [citado 1 Nov 2021]:363(2):94-103. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8571104/pdf/main.pdf

Bangash MN, Patel J, Parekh D. COVID-19 and the liver: Little cause for concern. Lancet Gastroenterol Hepatol [Internet]. 2020 [citado 2 Nov 2021];5(6):529-30. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7270582/pdf/main.pdf

Fan Z, Chen L, Li J, Yang J, Tian C, Zhang Y, et al. Clinical features of COVID-19-related liver functional abnormality. Clin Gastroenterol Hepatol [Internet].2020 [citado 1 Nov 2021];18(7):1561–6. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7194865/pdf/main.pdf

Published

2023-05-05

How to Cite

1.
Martínez Sarmiento A, Quintana MC, Ruíz MLM. Digestive manifestations in patients with COVID-19. Mediciego [Internet]. 2023 May 5 [cited 2024 Dec. 26];29(1):e3453. Available from: https://revmediciego.sld.cu/index.php/mediciego/article/view/3453

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Review article

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