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World J Gastroenterol. Dec 14, 2021; 27(46): 7969-7981
Published online Dec 14, 2021. doi: 10.3748/wjg.v27.i46.7969
COVID-19 status quo: Emphasis on gastrointestinal and liver manifestations
Abhishek Bhurwal, Carlos D Minacapelli, Evan Orosz, Kapil Gupta, Christopher Tait, Ishita Dalal, Clark Zhang, Eric Zhao, Vinod K Rustgi
Abhishek Bhurwal, Carlos D Minacapelli, Evan Orosz, Kapil Gupta, Christopher Tait, Ishita Dalal, Vinod K Rustgi, Department of Medicine, Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, United States
Abhishek Bhurwal, Carlos D Minacapelli, Evan Orosz, Kapil Gupta, Christopher Tait, Ishita Dalal, Vinod K Rustgi, Center for Liver Diseases and Masses, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, NJ 08901, United States
Clark Zhang, Eric Zhao, Department of Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ 08901, United States
Author contributions: Bhurwal A, Minacapelli CD, Orosz E, Gupta K, Tait C, Dalal I, Zhang C, Zhao E and Rustgi VK were involved in data collection, writing the manuscript, and editing the manuscript.
Conflict-of-interest statement: There is no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vinod K Rustgi, MD, Professor, Department of Medicine, Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, 1 Robert Wood Johnson Place Medical Education Building Rm No. 466, New Brunswick, NJ 08901, United States. vr262@rwjms.rutgers.edu
Received: April 28, 2021
Peer-review started: April 28, 2021
First decision: June 13, 2021
Revised: July 23, 2021
Accepted: November 25, 2021
Article in press: November 25, 2021
Published online: December 14, 2021
Processing time: 225 Days and 19.4 Hours
Abstract

The coronavirus disease 2019 (COVID-19) has caused one of the worst public health crises in modern history. Even though severe acute respiratory syndrome coronavirus 2 primarily affects the respiratory tract, gastrointestinal manifestations are well described in literature. This review will discuss the epidemiology, virology, manifestations, immunosuppressant states, and lessons learned from COVID-19. Observations: At the time of writing, COVID-19 had infected more than 111 million people and caused over 2.5 million deaths worldwide. Multiple medical comorbidities including obesity, pre-existing liver condition and the use of proton pump inhibitor have been described as risk factor for severe COVID-19. COVID-19 most frequently causes diarrhea (12.4%), nausea/vomiting (9%) and elevation in liver enzymes (15%-20%). The current data does not suggest that patients on immunomodulators have a significantly increased risk of mortality from COVID-19. The current guidelines from American Gastroenterological Association and American Association for the Study of Liver Diseases do not recommend pre-emptive changes in patients on immunosuppression if the patients have not been infected with COVID-19. Conclusions and relevance: The COVID-19 pandemic has prompted a change in structure and shape of gastroenterology departmental activities. Endoscopy should be performed only when necessary and with strict protective measures. Online consultations in the form of telehealth services and home drug deliveries have revolutionized the field.

Keywords: COVID-19; Status quo; Epidemiology; Virology; Gastrointestinal manifestations; Liver manifestations; Immunosuppressed states

Core Tip: The coronavirus disease 2019 (COVID-19) has caused one of the worst public health crises in modern history. Even though severe acute respiratory syndrome coronavirus 2 primarily affects the respiratory tract, gastrointestinal manifestations are well described in literature. This review will discuss the epidemiology, virology, manifestations, immunosuppressant states, and lessons learned from COVID-19.