A study published in Clinical Gastroenterology and Hepatology investigated the epidemiology, clinical presentation, molecular mechanisms, management, and prevention of SARS-CoV-2-associated diarrhea.

The study entailed a search from PubMed, EMBASE, and Web of Science to select studies documenting diarrhea and mechanisms of intestinal inflammation in patients with confirmed SARS-CoV-2 infection –up to March 2020.

The results depicted a diarrhea incidence rate of 2-50%; these episodes may occur before or after the emergence of the respiratory manifestations. The overall percentage of diarrhea onset was 10.4%. 

Gastrointestinal inflammation is common in patients with SARS-CoV-2 as the virus infests human cells through the angiotensin-converting enzyme 2 (ACE2), which is expressed in the lungs, as well as the upper esophagus, intestinal lining, colon, and liver. The management strategies for coronavirus disease 2019 (COVID-19) – caused by SARS-CoV-2 infection include – supportive care and symptomatic treatments. 

In addition, the likelihood of a fecal-oral route of SARS-CoV-2 transmission cannot be refuted. Thus, the screening and diagnostic techniques need prompt updating. Further research is warranted for devising optimal ways of preventing, managing, and treating diarrhea in COVID-19.

Further screening tests in patients presenting with diarrhea or acute gastrointestinal symptoms should be mandated to expedite COVID-19 diagnosis. The possibility of diarrhea being a predictive factor inCOVID-19 prognosis and to ascertain the impact of the disease on patients with diarrheal symptoms.

Source: Clinical Gastroenterology and Hepatology. 2020 Jul; 18(8): 1663–1672. doi:10.1016/j.cgh.2020.04.001