Diarrhea and COVID-19 Infection

The global COVID-19 pandemic has caused significant morbidity and mortality, thoroughly affected daily living, and caused severe economic disruption throughout the world. Pulmonary symptoms predominate and account for most of the associated morbidity and mortality. However, extrapulmonary manifestations are common in COVID-19 infections, including gastrointestinal symptoms, such as diarrhea. Diarrhea affects about 10% to 20% of COVID-19 patients. Diarrhea can occasionally be the presenting and only COVID-19 symptom. Diarrhea in COVID-19 subjects is usually acute but is occasionally chronic. It is typically mild-to-moderate and nonbloody. It is usually much less clinically important than pulmonary or potential thrombotic disorders. Occasionally the diarrhea can be profuse and life-threatening. The entry receptor for COVID-19, ACE-2 (angiotensin converting enzyme-2), is found throughout the GI tract, especially in the stomach and small intestine, which provides a pathophysiologic basis for local GI infection. COVID-19 virus has been documented in feces and in GI mucosa. Patients with preexisting diarrhea before contracting COVID-19 infection may have diarrhea exacerbation with COVID-19 infection, or alternatively the diarrhea may be incidental to COVID-19 infection. Treatment for COVID-19 infection, especially antibiotic therapy, is a common culprit. but secondary infections including bacteria, especially C. difficile, are sometimes implicated. Workup for diarrhea in hospitaliz...
Source: Gastroenterology Clinics of North America - Category: Gastroenterology Authors: Source Type: research