Gastrointestinal and LiverManifestations of COVID-19
GI/Liver Pathogenesis – Possible Explanations
- During the SARS-CoV outbreak of 2002-2003, up to 73% of patients had diarrhea, generally within the first week of the illness.
- Covid-19 has strong affinity for angiotensin-converting enzyme 2 receptor which is located in multiple human cell types, including enterocytes in the ileum and colon, hepatocytes and cholangiocytes.
- The binding efficiency is thought to be stronger for SARS-CoV-2 than the SARS-CoV-1 outbreak of 2002, which could likely explain its high rate of transmission to others.
- The binding of virus to primary intestinal epithelial cells also raises the prospect of fecal-oral transmission, which is as of yet unconfirmed for SARS-CoV-2.