The implications of COVID-19 for gastroenterology and hepatology: a state-of-the-art review

Abstract

COVID-19 has erupted as a global public health emergency, and data are emerging on the wider impacts of this viral respiratory infection. This state-of-the-art review includes ten publications from China about the impact of COVID-19 on gastrointestinal symptoms and liver disease. In addition to respiratory symptoms, some patients both present with and subsequently develop gastrointestinal symptoms, such as nausea or diarrhoea. COVID-19 can also be found in faeces, sometimes lasting for several days following a negative oropharyngeal test result. Abnormal serum liver function tests have been recorded, but these may be due to a deterioration of previously known chronic liver disease, ischaemia or hypoxia due to critical illness, or a drug-induced hepatotoxicity. Many existing care pathways for people with chronic gastrointestinal or liver disease have been abruptly halted in order to redirect staff and facilities to people acutely ill with COVID-19 and this may lead to an increase in morbidity and mortality in these cohorts.