Vijaya Chaitanya Bollampally*, Zainab Imtiaz, Abdul Gaffar Mohammed, Andikan Effiong Udoh, Saadiya Mushtaq, Krystal Amoroso, Sujan Poudel, Farheen Sana, Samar Abduljawad Eldahtoury, Salomi Paul, Mrinali Tripathi and Evgeni Mirkin


The pandemic of the coronavirus disease-19 (COVID-19), the causative agent of the severe acute respiratory syndrome-2 (SARS-CoV-2), has become a public health emergency of the international concern. Although COVID-19 has been reported principally to affect the respiratory system, other system’s involvement has also been reported. Gastrointestinal (GI) involvement has also been underlined in the published literature. Gastrointestinal involvement in SARS-CoV-2 usually corresponds to four situations: (a) gastrointestinal manifestation of COVID-19, (b) hepatobiliary manifestations, (c) pancreatic manifestation, and (d) COVID-19 infection in patients with gastrointestinal comorbidities. General gastrointestinal manifestations of the viral infection include anorexia, nausea, vomiting, abdominal pain, and diarrhea. Hepatobiliary manifestations include asymptomatic abnormal elevation of enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and bilirubin), and acute hepatitis. Pancreatic symptomology involves asymptomatic abnormal pancreatic enzyme elevation (lipase, amylase), and acute pancreatitis. Viral infection with GI comorbidities includes any GI malignancy, peptic ulcer disease, hepatitis, chronic liver disease (CLD), and inflammatory bowel disease (IBD). The pandemic of SARS-CoV-2 has become a unique challenge for the gastroenterologist. Various GI manifestations have been observed and reported in many cases, and even GI features may precede the classical respiratory signs and symptoms. In this review, we have summarized the information from published literature including, case reports and open-source data sets, to describe the spectrum of GI manifestations observed in COVID-19 cases.

Keywords: ALT, AST, GGT, IBD.

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