Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2021; 27(7): 561-575
Published online Feb 21, 2021. doi: 10.3748/wjg.v27.i7.561
Digestive system involvement of infections with SARS-CoV-2 and other coronaviruses: Clinical manifestations and potential mechanisms
Gao-Feng Zhan, Yue Wang, Ning Yang, Ai-Lin Luo, Shi-Yong Li
Gao-Feng Zhan, Yue Wang, Ai-Lin Luo, Shi-Yong Li, Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Ning Yang, Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Zhan GF, Wang Y, and Yang N reviewed the literature and drafted the manuscript; Luo AL and Li SY checked and revised the manuscript; all authors contributed to the conception and design of the review and approved the final manuscript for submission.
Conflict-of-interest statement: All the authors declare no conflict of interest related to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shi-Yong Li, MD, PhD, Doctor, Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. shiyongli@hust.edu.cn
Received: December 11, 2020
Peer-review started: December 11, 2020
First decision: December 27, 2020
Revised: December 28, 2020
Accepted: January 13, 2021
Article in press: January 13, 2021
Published online: February 21, 2021
Abstract

Although coronavirus (CoV) infection is often characterized by respiratory symptoms, the virus can also result in extrapulmonary symptoms, especially the symptoms related to the digestive system. The outbreak of coronavirus disease 2019 (COVID-19) is currently the world’s most pressing public health threat and has a significant impact on civil societies and the global economy. The occurrence of digestive symptoms in patients with COVID-19 is closely related to the development and prognosis of the disease. Moreover, thus far, there are no specific antiviral drug or vaccine approved for the treatment or prevention of COVID-19. Therefore, we elaborate on the effects of CoVs on the digestive system and the potential underlying mechanisms.

Keywords: SARS-CoV-2, Gastrointestinal diseases, Liver dysfunction, COVID-19, Coronavirus, Mechanisms

Core Tip: In this review, it is reported that coronavirus infections can cause a series of digestive diseases, and may also be accompanied by digestive manifestations and abnormal digestive function. Furthermore, the potential mechanisms of coronavirus disease 2019 on the digestive system, such as angiotensin-converting enzyme 2, immune injury, gut microbiota, hypoxemia, and psychological stress, are also discussed. This review provides a new perspective for the prevention and treatment of infections with severe acute respiratory syndrome coronavirus 2 and other coronaviruses.