Name : Noor Wahidah

NIM : P1337420220025

Grade : 2A

Gastrointestinal Manifestations of SARS-CoV-2 Infection

The global is witnessing a extreme public fitness hazard withinside the wake of the third
corona virus pandemic. The ailment changed into named coronavirus disease 2019 (COVID-19)
with the aid of using the World Health Organization, and the virus changed into termed SARS-
CoV-2 with the aid of using the International Committee on Taxonomy of Viruses. SARS-CoV-2
is a positive-sense, single-stranded RNA virus and has robust genetic similarity to bat
coronaviruses, however the intermediate reservoir has but to be identified. The Corona Virus
Disease-19 (COVID-19) isn't always restricted to the breathing gadget however has significant
involvement inclusive of the gastrointestinal (GI) tract and liver, with proof of extended fecal
losing and feco-oral transmission. Previously, enteric signs extended in SARS sufferers and
established viral replication withinside the patient's small intestinal mucosa. It is anticipated that
16%–73% of sufferers had diarrhea at some point of the path of SARS infection. Fecal losing of
SARS-CoV RNA changed into observed in 86%–100% of sufferers at some point of days 6–14 of
infection and will persist for >30 days of infection. It changed into sooner or later observed that
SARS-CoV binds to angiotensin-changing enzyme 2 (ACE2) receptors of the intestinal and
breathing tracts, that's the access factor for the virus to the epithelial cells. Similarly, up to 1 / 4 of
sufferers with MERS additionally suggested gastrointestinal signs inclusive of diarrhea or belly
pain. Again, MERS CoV may be detected in 15% of stool samples and will persist for as much as
24 days after diagnosis. It changed into proven that the human intestinal tract, inclusive of number
one intestinal epithelial cells, small gut explants, and intestinal organoids, is quite at risk of MERS-
CoV. Enteric manifestations of SAR-CoV-2 now no longer most effective pose critical diagnostic
undertaking to clinicians while dealing with sufferers with moderate COVID-19 signs on
preliminary presentation however additionally symbolize capability fecal transmission of this
virus.
 The most commonly reported gastrointestinal symptoms are diarrhea, nausea, vomiting,
and abdominal discomfort. Liver chemistry abnormalities are common and include elevations in
aspartate transferase, alanine transferase, and total bilirubin. Studies have shown that SARSCoV2
infects the gastrointestinal tract through its angiotensin II converting enzyme, which is expressed
in the enterocytes of the ileum and colon. Viral RNA has also been isolated from stool samples of
COVID19 patients, raising concerns about fecal transmission in addition to droplet transmission.
Although indirect evidence suggests possible fecal transmission of SARSCoV2, further efforts are
needed to determine the role of the fecal route of transmission.

This finding has stirred a hornet's nest not only from a more recent mode of virus spread,
but also from the risk of the unpredictable duration of the infectious potential of excretors. The
pandemic is changing the treatment of underlying chronic diseases such as inflammatory bowel
disease (IBD) and other diseases. In addition, performing endoscopic interventions in this
COVID19 era carries a high risk of contamination for the gastroenterologist, as it is an aerosol-
generating procedure. GI manifestations are not uncommon in patients with COVID19, and what
is more intriguing is the presence of a subset of these cases presenting only with GI symptoms.
The fecal spread of the virus objectively establishes gastrointestinal involvement, but also
underlines its impact on the formulation of preventive strategies. For the practicing
gastroenterologist, in addition to patient management, personal safety is also at the fore. The use
of “telemedicine” facilities for patient management, restricting unnecessary procedures, and
adhering to strict protection strategies are keys to navigating these difficult times.
 References

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Gastrointestinal Manifestations of SARS-CoV-2 Infection and Virus Load in Fecal Samples From
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Cha, M. H., Regueiro, M., Sandhu, D. S. (2020). Gastrointestinal and hepatic manifestations of
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Dhar, J., Samanta, J., Kochhar, R., (2020). Corona Virus Disease-19 pandemic: The
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