Published online Aug 6, 2023. doi: 10.12998/wjcc.v11.i22.5252
Peer-review started: April 20, 2023
First decision: June 7, 2023
Revised: June 10, 2023
Accepted: July 3, 2023
Article in press: July 3, 2023
Published online: August 6, 2023
It is common for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to occur in the gastrointestinal tract, which can present itself as an initial symptom. The severity of coronavirus disease 2019 (COVID-19) is often reflected in the prevalence of gastrointestinal symptoms. COVID-19 can damage the nerve supply to the digestive system, leading to gastrointestinal autonomic dysfunction. There is still much to learn about how COVID-19 affects the autonomic nervous system and the gastrointestinal tract.
To thoroughly explore the epidemiology and clinical aspects of COVID-19-induced gastrointestinal autonomic dysfunction, including its manifestations, potential mechanisms, diagnosis, differential diagnosis, impact on quality of life, prognosis, and management and prevention strategies.
We conducted a thorough systematic search across various databases and performed an extensive literature review. Our review encompassed 113 studies published in English from January 2000 to April 18, 2023.
According to most of the literature, gastrointestinal autonomic dysfunction can seriously affect a patient's quality of life and ultimate prognosis. Numerous factors can influence gastrointestinal autonomic nervous functions. Studies have shown that SARS-CoV-2 has a well-documented affinity for both neural and gastrointestinal tissues, and the virus can produce various gastrointestinal symptoms by reaching neural tissues through different pathways. These symptoms include anorexia, dysgeusia, heartburn, belching, chest pain, regurgitation, vomiting, epigastric burn, diarrhea, abdominal pain, bloating, irregular bowel movements, and constipation. Diarrhea is the most prevalent symptom, followed by anorexia, nausea, vomiting, and abdominal pain. Although COVID-19 vaccination may rarely induce autonomic dysfunction and gastrointestinal symptoms, COVID-19-induced autonomic effects significantly impact the patient's condition, general health, prognosis, and quality of life. Early diagnosis and proper recognition are crucial for improving outcomes. It is important to consider the differential diagnosis, as these symptoms may be induced by diseases other than COVID-19-induced autonomic dysfunction. Treating this dysfunction can be a challenging task.
To ensure the best possible outcomes for COVID-19 patients, it is essential to take a multidisciplinary approach involving providing supportive care, treating the underlying infection, managing dysfunction, monitoring for complications, and offering nutritional support. Close monitoring of the patient's condition is crucial, and prompt intervention should be taken if necessary. Furthermore, conducting thorough research on the gastrointestinal autonomic dysfunction caused by COVID-19 is vital to manage it effectively.
Core Tip: As a systemic disease, coronavirus disease 2019 (COVID-19) can impact various organs in the human body, including the autonomic nervous system and gastrointestinal tract. Our team conducted a systematic review to better understand the clinical range of COVID-19's impact on gastrointestinal autonomic dysfunction. We examined the clinical manifestations, potential mechanisms, diagnosis, differential diagnosis, effects on quality of life, prognosis, management, and prevention of COVID-19-induced gastrointestinal autonomic dysfunction. Most of the literature suggests that gastrointestinal autonomic dysfunction can be severe and negatively impact a patient's quality of life and prognosis. As a result, a multidisciplinary approach is needed to manage this dysfunction. However, further research is necessary to study COVID-19-induced gastrointestinal autonomic dysfunction effectively.