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World J Clin Cases. Jul 6, 2021; 9(19): 4969-4979
Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.4969
Remarkable gastrointestinal and liver manifestations of COVID-19: A clinical and radiologic overview
Li-Guang Fang, Quan Zhou
Li-Guang Fang, Quan Zhou, Department of Medical Imaging, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou 510630, Guangdong Province, China
Author contributions: All the authors participated in the literature search and selection of articles; Fang LG designed the review and wrote the first draft of the manuscript; Zhou Q revised the first draft of the manuscript; Fang LG summarized the data in the table.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Quan Zhou, MD, Professor, Department of Medical Imaging, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), No. 183 Zhongshan Avenue West, Tianhe District, Guangzhou 510630, Guangdong Province, China. zhouquan3777@smu.edu.cn
Received: January 23, 2021
Peer-review started: January 23, 2021
First decision: February 28, 2021
Revised: March 13, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: July 6, 2021
Processing time: 152 Days and 5.4 Hours
Abstract

The coronavirus disease 2019 (COVID-19) raging around the world still has not been effectively controlled in most countries and regions. As a severe acute respiratory syndrome coronavirus, in addition to the most common infectious pneumonia, it can also cause digestive system disease such as diarrhea, nausea, vomiting, liver function damage, etc. In medical imaging, it manifests as thickening of the intestinal wall, intestinal perforation, pneumoperitoneum, ascites and decreased liver density. Angiotensin-converting enzyme 2 has great significance in COVID-19-related digestive tract diseases. In this review, we summarized the data on the clinical and imaging manifestations of gastrointestinal and liver injury caused by COVID-19 so far and explored its possible pathogenesis.

Keywords: COVID-19; SARS-CoV-2; Gastrointestinal; Liver; Radiologic manifestations; Angiotensin-converting enzyme 2; Computed tomography

Core Tip: There are few reviews on the clinical and radiologic manifestations of gastrointestinal and liver in coronavirus disease 2019 (COVID-19). Here, we review the significant information on the management of patients with COVID-19 and the mechanism of how angiotensin-converting enzyme 2, the key factor of COVID-19 infection, relates to severe acute respiratory syndrome coronavirus 2 with digestive tract symptoms. The potential mechanism of fatty change of the liver is discussed in this review as well.