Gastrointestinal Signs and Symptoms in the Course of COVID-19

Nausea/vomiting, diarrhea, abdominal pain, and ageusia are gastrointestinal (GI) symptoms commonly recorded in the pandemic. The gastrointestinal system (GIS) is important in diagnostic procedures screening for COVID-19. This chapter aims to highlight this important aspect of the course of COVID-19, with a special emphasis on diagnostic opportunities. Many articles cited that GIS is closely related to COVID-19 in certain aspects. First of all, GI complaints and their severity show a strong correlation with the severity of the disease. Second, GI signs and symptoms are associated with higher AST and ALT and coagulation deficiencies. Patients with GI signs tend to have fever more frequently; however, they have a less severe course disease. Liver injury is seen more commonly in males and associated with lymphocytopenia, neutropenia. It has been observed that AST is associated with mortality in COVID-19. Inflammatory bowel diseases are not a high risk for COVID-19. The objective of this chapter is to highlight the value of GI signs and symptoms in the evaluation of the patient suspected to have COVID-19 and to focus on the need to assess specific clues ruling in and out the disease.

Keywords: ACE2 receptors, Anal swab, COVID-19, Diagnosis, Fecal RNA, Gastrointestinal complaints, Inflammatory bowel diseases, Liver disease, Liver enzymes.