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    Gastrointestinal and Liver Manifestations of COVID-19

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    Author
    Agarwal, A.
    Chen, A.
    Ravindran, N.
    To, C.
    Thuluvath, P.J.
    Date
    2020
    Journal
    Journal of Clinical and Experimental Hepatology
    Publisher
    Elsevier B.V.
    Type
    Article
    
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    https://doi.org/10.1016/j.jceh.2020.03.001
    Abstract
    The worldwide pandemic of COVID-19, caused by the virus SARS-CoV,-2 has continued to progress, and increasing information is becoming available about the incidence of digestive symptoms as well as abnormal liver-associated enzymes in patients who are infected. These are postulated to be related to the virus's use of ACE-2 receptors located on certain intestinal cells, cholangiocytes, and hepatocytes. This brief review summarizes the available limited data on digestive manifestations of COVID-19. A significant proportion of COVID-19 patients can present initially with only digestive complaints. The most common digestive symptoms are anorexia, nausea, vomiting, and diarrhea. Liver-related transaminases are elevated in a substantial proportion of patients, although generally only mildly elevated. Currently there is no firm evidence to suggest that severity of digestive symptoms corresponds to severity of COVID-19 clinical course, however, more severe alterations in liver enzymes may correlate with worse clinical course. Given use of antiviral and antibacterial agents in sicker patients, drug-induced liver injury cannot be ruled out either in these cases. Although viral RNA can be detected in stool, it is unclear whether fecal-oral transmission can be achieved by the virus. As further data becomes available, our understanding of the digestive manifestations of COVID-19 will continue to evolve.
    Keyword
    Coronavirus Disease 2019 (COVID-19)
    SARS-CoV-2
    Signs and Symptoms, Digestive
    Liver
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85083093762&doi=10.1016%2fj.jceh.2020.03.001&partnerID=40&md5=e8f101180cdc8c094bbff8282bb192a3; http://hdl.handle.net/10713/12616
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jceh.2020.03.001
    Scopus Count
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    UMB Coronavirus Publications
    UMB Open Access Articles 2020

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