Introduction: Gastrointestinal (GI) manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) COVID-19 infections have been an area of active interest since early in the pandemic. GI symptoms including diarrhea, anorexia, and nausea have been commonly reported. A few studies have described “COVID-19 related inflammatory lesions” in the GI tract but there is very limited information on acute and chronic endoscopic findings in COVID-19 patients. Methods: Endoscopy reports performed at Advocate Lutheran General Hospital in patients infected with COVID-19 were reviewed between March 2020 to February 2021. Endoscopic findings of patients were compared between those who had a GI procedure within 14 days of their first positive PCR test for COVID-19 (Group 1) versus those who had a procedure greater than 14 days after their first positive PCR test for COVID-19 (Group 2). Between group differences regarding endoscopic findings and timing of procedure were compared using the chi square test. Results: There were 4714 encounters of COVID-19 at our facility and 45 patients had an esophagogastroduodenoscopy (EGD), colonoscopy, or both during their hospitalization. A total of 53 procedures were performed: 35 (69%) were EGDs and 16 (31%) were colonoscopies. Of the 35 EGDs, 15 (43%) were categorized to Group 1 and 20 (57%) to Group 2. 6 of 16 colonoscopies (37.5%) were categorized to Group 1 and 10 (62.5%) to Group 2. In group 1, 2 (13%) had normal EGDs and 2 (33%) had normal colonoscopies. In group 2, 6 (30%) had normal EGDs and 5 (50%) normal colonoscopies were found. Endoscopic findings involved non-specific inflammation in the stomach (characterized by erythema and erosions), (7 (47%) in group 1; 8 (40%) in group 2) and duodenum (2 (13%) in group 1; 1 (5%) in group 2). A small number of cases of esophagitis (2 (13%) in group 1; 4 (20%) in group 2) and recto-sigmoid ulcerations (1 (17%) in group 1; 1 (10%) in group 2) were described. Other endoscopic findings are as listed in Table 1. There were no statistical differences in the findings between Group 1 and Group 2 (p= 0.30). Furthermore, histological findings did not reveal specific infection related pathology. Conclusion: In a group of 45 patients infected with COVID-19, there was no endoscopic evidence of specific acute or chronic infection-related pathology. These findings do not support the concept of COVID-19 related GI mucosal disease.Table 1.: List of various pathological findings noted in both groups. Divided by anatomical locationFigure 1.: Endoscopic findings of patients with COVID-19. A. Minimal inflammation characterized by erythema seen in the gastric antrum. B. Localized minimal inflammation characterized by erythema seen in the gastric body. C. Duodenal erosions seen in the duodenal bulb. D. Ulceration and mucosal edema seen in the rectum