EFFECT OF COVID-19 ON GASTROINTESTINAL TRACT AND LIVER, MANIFESTATIONS, PROGNOSIS, MECHANISMS, TREATMENT, AND CHALLENGES: A COMPREHENSIVE REVIEW

Abstract

Background: The first case of coronavirus was found in December 2019 in Wuhan a city in China since then it has severe impact all over the world. The typical signs and symptoms of coronavirus patients consist of cough, fever, lethargy, and shortness of breath (SOB). Objectives: The current review contains summarized and complete information on the effect of coronavirus on GIT, Liver and its manifestations, prognosis, mechanisms, treatment, and challenges. Methodology: The data was collected via an electronic search of numerous scientific sources including Google scholar, PubMed, and Science Direct. Results: The main complaints in COVID-19 positive patients are linked to the respiratory system but many patients also complained of gastrointestinal problems like vomiting, abdominal pain, diarrhoea, and in some cases, anorexia, increased acidity, and bloating. The mechanisms of GI damage in corona-virus patients are direct virus-mediated cytotoxic damage in the intestinal epithelium, dysregulation of the RAAS in the intestinal epithelium, malabsorption of tryptophan in the intestinal epithelium. Various scientific studies also report that COVID-19 patients had abnormal levels of ALT and AST suggesting a possible liver injury. The possible mechanisms of liver damage in corona-virus patients are direct hepatic infection by corona-virus, cytokine storm, and drug-induced damage. The prognosis is poor in both GI and liver abnormalities in corona-virus patients. According to some studies, patients with considerable liver injury should be treated with anti-inflammatory, hepatoprotective, and jaundice-decreasing agents. Natural plants and herbs can be used in coronavirus patients with GI and liver abnormalities. However, further research is necessary in this area for a complete assessment of the effect of coronavirus infection on GI and liver abnormalities and appropriate testing of therapeutic agents used against these abnormalities. Conclusion: In a nutshell, our results conclude that both gastrointestinal symptoms and liver damage are not unusual in patients with coronavirus infection. Severe coronavirus patients had a greater risk of developing gastrointestinal symptoms and liver damage.