Published online Apr 7, 2021. doi: 10.3748/wjg.v27.i13.1255
Peer-review started: January 20, 2021
First decision: February 9, 2021
Revised: February 10, 2021
Accepted: March 8, 2021
Article in press: March 8, 2021
Published online: April 7, 2021
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can progress to a severe respiratory and systemic disease named coronavirus disease–2019 (COVID-19). The most common symptoms are fever and respiratory discomfort. Nevertheless, gastrointestinal infections have been reported, with symptoms such as diarrhea, nausea, vomiting, abdominal pain, and lack of appetite. Importantly, SARS-CoV-2 can remain positive in fecal samples after nasopharyngeal clearance. After gastrointestinal SARS-CoV-2 infection and other viral gastrointestinal infections, some patients may develop alterations in the gastrointestinal microbiota. In addition, some COVID-19 patients may receive antibiotics, which may also disturb gastrointestinal homeostasis. In summary, the gastrointestinal system, gut microbiome, and gut-lung axis may represent an important role in the development, severity, and treatment of COVID-19. Therefore, in this review, we explore the current pieces of evidence of COVID-19 gastrointestinal manifestations, possible implications, and interventions.
Core Tip: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can progress to a severe respiratory and systemic disease named coronavirus disease–2019 (COVID-19). Nevertheless, SARS-CoV-2 can also generate a gastrointestinal infection. In this review, we explore the impact of COVID-19 on the gastrointestinal system, gut microbiome, and the gut-lung axis and the severity and possible implications and interventions in COVID-19 patients.