Alliance for Pandemic Preparedness

May 1, 2020

Addressing multiple gastroenterological aspects of COVID-19



  • Eder et al. review current evidence of gastrointestinal (GI) involvement in patients with SARS-CoV-2 infection. Approximately 10% of COVID-19 cases experience GI symptoms that precede respiratory symptoms and fever, and 50% of all cases report GI symptoms. Although there is growing evidence that GI manifestations are an important clinical characteristic, the mechanisms remain unclear.
  • Although there is evidence of detection of RNA in stool (including after tests from oral or nasopharyngeal swabs are negative), there is currently no evidence of fecal-oral transmission.
  • There is some evidence that patients with diarrhea have more severe symptoms of pneumonia.
  • Pathogenesis may be explained by the expression of angiotensin converting enzyme 2 (ACE2) proteins along the respiratory and gastrointestinal tracts. SARS-CoV-2 has a high affinity to ACE2 proteins, which serve as an entry receptor for SARS-CoV-2. 

Eder et al. (May 1, 2020). Addressing multiple gastroenterological aspects of COVID-19. Polish Archives of Internal Medicine.