Diarrhea and other Gastrointestinal Features of COVID-19.

Diarrhea is one of the symptom of COVID-19 and occurred in about 29.3% in a Chinese report (1), while 10.4% of patients had it in a meta-analysis (2).

Gastrointestinal involvement is explained by high degree of ACE-2 receptors expression in the gut. As a result, viral RNA may be detected in the feces many weeks after COVID-19 infection and can also be a source of spread of COVID-19 (3).

1. Article Clinical Characteristics of COVID-19 Patients With Digestive...

2. Article Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiolo...

3. Article COVID-19: Gastrointestinal Manifestations and Potential Feca...

COVID 19 seems to strive more in diseased (include diarrhoea) individuals since diseases may reduce the immunity of an individual.

Good topic

The question is diarrhea because ACE-2 receptors in gut or there is other unknown reasons??

Extrapulmonary manifestation involves the gastrointestinal system (GI), hepatobiliary, kidney, CNS, heart cells, as well as the blood and the immune system due to the expression of ACE2 receptors in these organs. The involvement of the GI system leads to nausea or vomiting and loose motion.

It happen on some occasions because the virus can be eliminated by feces

Thank you so much Luis Rodrigo and Muhammad Yousuf Sir. It is very helpful.

It may be a symptom.

The pathophysioloy of the infectious organism that affects the upper respiratory tract, provides an association to its movement to the GIT tract and presenting as one of symptoms for COVID 19

The virus can ce eliminated by stools and cause infection at the colon

I support the views of Dr.Muhammod Yousef that diarrhea can occur in COVID-19 patients.

yes diarrhea could be a presentation of COVID-19 infection

You may read it

https://www.healio.com/news/gastroenterology/20200318/diarrhea-may-be-common-symptom-in-patients-with-covid19

One of my relatives who was diagnosed as COVID-19 had diarrhoea. Unfortunately, she lost her life due to COVID-19.

Follow

COVID-19 case may present with Diarrhoea but Diarrhoea can never cause COVID-19.

Please see the link below.

https://www.cghjournal.org/article/S1542-3565(20)30481-X/pdf

Diarrhea is a frequent symptom in coronavirus infections; it was detected in up to 30% of patients with MERS-CoV and 10.6% of patients with SARS-CoV.

Thank you all for your information. It is really helpful.

SARS-CoV uses the angiotensin-converting enzyme 2 (ACE2) and the serine protease TMPRSS2 for S protein priming. ACE2 and TMPRSS2 are not only expressed in the lung, but also in the small intestinal epithelia. ACE2 is expressed furthermore in the upper esophagus, liver, and colon. SARS-CoV-2 binding affinity to ACE2 is significantly higher (10–20 times) compared with SARS-CoV.

That is why diarrhoea is also a clinical presentation due to direct invasion of the virus to GIT.

The incidence of diarrhea is currently underestimated and further studies are needed to quantify the exact burden of diarrhea to compare the sensitivity of fecal and nasopharyngeal tests, to evaluate whether diarrhea is a predictive factor for prognosis, and to clarify the effects of COVID-19 in patients with underlying

gastrointestinal diseases.

Many reports showed a gastrointestinal symptoms in patient with Covid-19, like diarrhea

Ther is a possible association, but must be confirmed with cultures or isolations of the virus from stools by PCR examination

The gastrointestinal tract expresses ACE2, leading to a SARS-COV2 attack on the system and the development of symptoms like diarrhoea, abdominal pain and vomiting.

Please follow the link below:

Article COVID-19 presenting with diarrhoea and hyponatraemia

Golap Babu

Article Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiolo...

A patient with diarrhoea condition may aggravate complexity if contracted Covid- 19. Many disease conditions may lead to reduction in immune system which, then worsen when contracted with Covid - 19.

Now most of the children with covid 19are presenting with fever pain abdomen adnd diarrhea in our COVID-19 hospital. Odisha

Agree with Respected Fisayo Bamisaye

Small bowel diarrhoea is more common with malabsorption and some weight loss. Approxamitely 20-25 % seen even other symptoms may be negligible.

Please read the attached links:

https://www.livescience.com/coronavirus-diarrhea-symptoms.html

https://theconversation.com/diarrhoea-stomach-ache-and-nausea-the-many-ways-covid-19-can-affect-your-gut-145440

https://www.aarp.org/health/conditions-treatments/info-2020/unusual-coronavirus-symptoms.html

It is a common clinical manifestation associated to others

its depends on patient immunity .

To gain entry into cells, SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2), a protein that is highly expressed in the human intestine.3 Evaluation of the distribution of the virus in human biological samples revealed that more than half of the fecal samples of patients with COVID-19-driven pneumonia were positive for SARS-CoV-2, and about one-fifth of infected patients remained positive in stools after becoming negative in respiratory samples.4 These observations suggest that human intestinal tract could serve as an alternative infection route for SARS-CoV-2. If this is true, we could hypothesize that patients with active IBD face an increased risk of SARS-CoV-2 infection, as inflammation can enhance ACE2 expression.

Expression of Receptors for SARS-CoV-2 in the Gut of Patients with Inflammatory Bowel Disease

doi: 10.5009/gnl20112

COVID.19 induce malabsorption , and then diarrhea

In some occasions may be associated by colonization of the colonic mucosa

virus invade Small bowel and induce malabsorption