Diarrhea in patients with COVID-19 and pos-COVID syndrome
Keywords:
SARS-CoV-2, COVID-19, diarrhea, post-COVID-19 syndromeAbstract
COVID-19, the current global pandemic, is produced by the SARS-CoV-2 coronavirus, capable of causing a severe acute respiratory syndrome. This disease is multi-systemic and heterogeneous, and is not always related to the severity of the lung disease. In fact, up to a third of the patients can show gastrointestinal symptoms like diarrhea—which has been reported as one of the most impactful—both as a consequence of the acute infection and of the post-COVID-19 syndrome. In addition, the various treatment schemes indicated may have effects on diarrhea, what makes them a frequent reason for consultation in the specialty of gastroenterology. Patients with previous intestinal diseases could be more susceptible to this manifestation. Due to this, an exhaustive search of articles on the theme, published in Cuban and foreign journals of high visibility, was carried out, with the aim of exposing the causes and characteristics of the diarrhea that occurs in patients infected by SARS-CoV-2. 168 articles were compiled, of which 30 were used in the current review, which will allow documenting the attending physician for a better management of diarrhea in patients in the mentioned phases.Downloads
Download data is not yet available.
References
1. Pan L, Mu M, Yang P, et al. Clinical characteristics of COVID-19 patients with digestive symptoms in Hubei, China: A descriptive, cross-sectional, multicenter study. Am J Gastroenterol. 2020;115(5):766-73. DOI: 10.14309/ajg.0000000000000620.
2. Infante Velázquez M. Implicaciones de la infección por el nuevo coronavirus SARS-Cov-2 para el sistema digestivo. Arch Cubanos Gastroenterol [Internet]. 2020 [citado 14/04/2021];1(2). Disponible en: https://revgastro.sld.cu/index.php/gast/article/view/38
3. World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 [Internet]. Geneva: World Health Organization; 2021 [citado 14/01/2022]. Disponible en: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1
4. Norsa L, Indriolo A, Sansotta N, et al. Uneventful Course in Patients with Inflammatory Bowel Disease during the Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in Northern Italy. Gastroenterology. 2020;159(1):371-2. Citado en PubMed; PMID: 32247695.
5. D'Amico F, Baumgart DC, Danese S, et al. Diarrhea during COVID-19 infection: Pathogenesis, Epidemiology, Prevention, and Management. Clin Gastroenterol Hepatol. 2020;18(8):1663-72. Citado en PubMed; PMID: 32278065.
6. Mönkemüller K, Fry L, Rickes S. COVID-19, coronavirus, SARS-CoV-2 and the small bowel. Rev Esp Enferm Dig. 2020;112(5):383-8. Citado en PubMed; PMID: 32343593.
7. Penninger JM, Grant MB, Sung JJY. The Role of Angiotensin Converting Enzyme 2 in Modulating Gut Microbiota, Intestinal Inflammation, and Coronavirus Infection. Gastroenterology. 2021;160(1):39-46. Citado en PubMed; PMID: 33130103.
8. Gu S, Chen Y, Wu Z, et al. Alterations of the Gut Microbiota in Patients With Coronavirus Disease 2019 or H1N1 Influenza. Clin Infect Dis [Internet]. 2020 [citado 19/04/2021];71(10):2669-78. Disponible en: https://academic.oup.com/cid/article/71/10/2669/5851452?login=false
9. Castañeda Guillot C. Microbiota intestinal y salud infantil. Rev Cubana Pediatr [Internet]. 2018 [citado 19/04/2021];90(1):94-110. Disponible en: http://www.revpediatria.sld.cu/index.php/ped/article/view/320/176
10. Patel P, Roper J. Gut Microbiome Composition is associated with COVID-19 Disease Severity. Gastroenterology [Internet]. 2021 [citado 15/10/2021];161(2):722-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116123/
11. Azkur AK, Akdis M, Azkur D, et al. Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19. Allergy. 2020;75(7):1564-81. Citado en PubMed; PMID: 32396996.
12. Castañeda Guillot C. Microbiota pulmonar y el eje intestino-pulmón. Rev Cubana Pediatr [Internet]. 2021 [citado 12/01/2022];93(4). Disponible en: http://www.revpediatria.sld.cu/index.php/ped/article/view/1403
13. Ha S, Jin B, Clemmensen B, et al. Serotonin is elevated in COVID-19-associated diarrhoea. Gut. 2021;70(10):2015-7. Citado en PubMed; PMID: 33402416.
14. Xu J, Wu Z, Zhang M, et al. The Role of the Gastrointestinal System in Neuroinvasion by SARS-CoV-2. Front Neurosci. 2021;15. DOI: 10.3389/fnins.2021.694446.
15. Margolis KG, Cryan JF, Mayer EA. The Microbiota-Gut-Brain Axis: From Motility to Mood. Gastroenterology. 2021;160(5):1486-501. Citado en PubMed; PMID: 33493503.
16. Marasco G, Lenti MV, Cremon C, et al. Implications of SARS-CoV-2 infection for neurogastroenterology. Neurogastroenterol Motil. 2021;33(3):e14104. Citado en PubMed; PMID: 33591607.
17. Perisetti A, Gajendran M, Goyal H. Putative Mechanisms of Diarrhea in COVID-19. Clin Gastroenterol Hepatol. 2020;18(13):3054-5. DOI: 10.1016/j.cgh.2020.06.008.
18. Rizvi A, Patel Z, Liu Y, et al. Gastrointestinal Sequelae 3 and 6 Months After Hospitalization for Coronavirus Disease 2019. Clin Gastroenterol Hepatol. 2021;19(11):2438-40. Citado en PubMed; PMID: 34217880.
19. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut. 2021;70(4):698-706. Citado en PubMed; PMID: 33431578.
20. Chen Y, Gu S, Chen Y, et al. Six-month follow-up of gut microbiota richness in patients with COVID-19. Gut. 2022;71(1):222-5. Citado en PubMed; PMID: 33833065.
21. Johnson DA. Post-COVID-19 GI Symptoms: Are We in for the Long Haul? [Internet]. New York: Medscape; 2021 [citado 12/10/2021]. Disponible en: https://www.medscape.com/viewarticle/950733
22. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology. 2017;152(5):1042-54. DOI: 10.1053/j.gastro.2016.12.039.
23. Noviello D, Costantino A, Muscatello A, et al. 782 Persistent Gastrointestinal Symptoms and Chronic Fatigue after SARS-COV-2 infection. Gastroenterology [Internet]. 2021 [citado 12/10/2021];160(6):S-158. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108222/
24. Vespa E, Pugliese N, Colapietro F, et al. Stay (GI) Healthy: COVID-19 and Gastrointestinal Manifestations. Tech Innov Gastrointest Endosc. 2021;23(2):179-89. DOI: 10.1016/j.tige.2021.01.006.
25. Gao QY, Chen YX, Fang JY. 2019 Novel coronavirus infection and gastrointestinal tract. J Dig Dis. 2020;21(3):125-6. Citado en PubMed; PMID: 32096611.
26. Di Renzo L, Merra G, Esposito E, et al. Are probiotics effective adjuvant therapeutic choice in patients with COVID-19? Eur Rev Med Pharmacol Sci. 2020;24(8):4062-3. DOI: 10.26355/eurrev_202004_20977.
27. Biliński J, Winter K, Jasiński M, et al. Rapid resolution of COVID-19 after faecal microbiota transplantation. Gut [Internet]. 2022 [citado 02/05/2022];71(1):230-2. Disponible en: https://gut.bmj.com/content/71/1/230?fbclid=IwAR38LOPiG_yGb7GstGu_Ar3guAsjOuzuqBnGhE_5lam8sJtqECOEdcZA1GQ
28. Liu F, Ye S, Zhu X, et al. Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients. J Med Case Reports [Internet]. 2021 [citado 12/10/2021];15(60). Disponible en: https://doi.org/10.1186/s13256-020-02583-7
29. Samada Suárez M, Chao González L. Enfermedad inflamatoria intestinal y la COVID 19. Boletín Científico del Cimeq [Internet]. 2020 [citado 25/04/2021];1(11):4-5. Disponible en: https://instituciones.sld.cu/bolcimeq/2020/06/01/enfermedad-inflamatoria-intestinal-y-la-covid-19/
30. Hisamatsu T. Management of inflammatory bowel disease during the COVID-19 pandemic. Immunol Med [Internet]. 2021 [citado 12/10/2021];45(3):128-35. Disponible en: https://www.tandfonline.com/doi/full/10.1080/25785826.2021.1978205
2. Infante Velázquez M. Implicaciones de la infección por el nuevo coronavirus SARS-Cov-2 para el sistema digestivo. Arch Cubanos Gastroenterol [Internet]. 2020 [citado 14/04/2021];1(2). Disponible en: https://revgastro.sld.cu/index.php/gast/article/view/38
3. World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 [Internet]. Geneva: World Health Organization; 2021 [citado 14/01/2022]. Disponible en: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1
4. Norsa L, Indriolo A, Sansotta N, et al. Uneventful Course in Patients with Inflammatory Bowel Disease during the Severe Acute Respiratory Syndrome Coronavirus 2 Outbreak in Northern Italy. Gastroenterology. 2020;159(1):371-2. Citado en PubMed; PMID: 32247695.
5. D'Amico F, Baumgart DC, Danese S, et al. Diarrhea during COVID-19 infection: Pathogenesis, Epidemiology, Prevention, and Management. Clin Gastroenterol Hepatol. 2020;18(8):1663-72. Citado en PubMed; PMID: 32278065.
6. Mönkemüller K, Fry L, Rickes S. COVID-19, coronavirus, SARS-CoV-2 and the small bowel. Rev Esp Enferm Dig. 2020;112(5):383-8. Citado en PubMed; PMID: 32343593.
7. Penninger JM, Grant MB, Sung JJY. The Role of Angiotensin Converting Enzyme 2 in Modulating Gut Microbiota, Intestinal Inflammation, and Coronavirus Infection. Gastroenterology. 2021;160(1):39-46. Citado en PubMed; PMID: 33130103.
8. Gu S, Chen Y, Wu Z, et al. Alterations of the Gut Microbiota in Patients With Coronavirus Disease 2019 or H1N1 Influenza. Clin Infect Dis [Internet]. 2020 [citado 19/04/2021];71(10):2669-78. Disponible en: https://academic.oup.com/cid/article/71/10/2669/5851452?login=false
9. Castañeda Guillot C. Microbiota intestinal y salud infantil. Rev Cubana Pediatr [Internet]. 2018 [citado 19/04/2021];90(1):94-110. Disponible en: http://www.revpediatria.sld.cu/index.php/ped/article/view/320/176
10. Patel P, Roper J. Gut Microbiome Composition is associated with COVID-19 Disease Severity. Gastroenterology [Internet]. 2021 [citado 15/10/2021];161(2):722-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116123/
11. Azkur AK, Akdis M, Azkur D, et al. Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19. Allergy. 2020;75(7):1564-81. Citado en PubMed; PMID: 32396996.
12. Castañeda Guillot C. Microbiota pulmonar y el eje intestino-pulmón. Rev Cubana Pediatr [Internet]. 2021 [citado 12/01/2022];93(4). Disponible en: http://www.revpediatria.sld.cu/index.php/ped/article/view/1403
13. Ha S, Jin B, Clemmensen B, et al. Serotonin is elevated in COVID-19-associated diarrhoea. Gut. 2021;70(10):2015-7. Citado en PubMed; PMID: 33402416.
14. Xu J, Wu Z, Zhang M, et al. The Role of the Gastrointestinal System in Neuroinvasion by SARS-CoV-2. Front Neurosci. 2021;15. DOI: 10.3389/fnins.2021.694446.
15. Margolis KG, Cryan JF, Mayer EA. The Microbiota-Gut-Brain Axis: From Motility to Mood. Gastroenterology. 2021;160(5):1486-501. Citado en PubMed; PMID: 33493503.
16. Marasco G, Lenti MV, Cremon C, et al. Implications of SARS-CoV-2 infection for neurogastroenterology. Neurogastroenterol Motil. 2021;33(3):e14104. Citado en PubMed; PMID: 33591607.
17. Perisetti A, Gajendran M, Goyal H. Putative Mechanisms of Diarrhea in COVID-19. Clin Gastroenterol Hepatol. 2020;18(13):3054-5. DOI: 10.1016/j.cgh.2020.06.008.
18. Rizvi A, Patel Z, Liu Y, et al. Gastrointestinal Sequelae 3 and 6 Months After Hospitalization for Coronavirus Disease 2019. Clin Gastroenterol Hepatol. 2021;19(11):2438-40. Citado en PubMed; PMID: 34217880.
19. Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity and dysfunctional immune responses in patients with COVID-19. Gut. 2021;70(4):698-706. Citado en PubMed; PMID: 33431578.
20. Chen Y, Gu S, Chen Y, et al. Six-month follow-up of gut microbiota richness in patients with COVID-19. Gut. 2022;71(1):222-5. Citado en PubMed; PMID: 33833065.
21. Johnson DA. Post-COVID-19 GI Symptoms: Are We in for the Long Haul? [Internet]. New York: Medscape; 2021 [citado 12/10/2021]. Disponible en: https://www.medscape.com/viewarticle/950733
22. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-analysis. Gastroenterology. 2017;152(5):1042-54. DOI: 10.1053/j.gastro.2016.12.039.
23. Noviello D, Costantino A, Muscatello A, et al. 782 Persistent Gastrointestinal Symptoms and Chronic Fatigue after SARS-COV-2 infection. Gastroenterology [Internet]. 2021 [citado 12/10/2021];160(6):S-158. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8108222/
24. Vespa E, Pugliese N, Colapietro F, et al. Stay (GI) Healthy: COVID-19 and Gastrointestinal Manifestations. Tech Innov Gastrointest Endosc. 2021;23(2):179-89. DOI: 10.1016/j.tige.2021.01.006.
25. Gao QY, Chen YX, Fang JY. 2019 Novel coronavirus infection and gastrointestinal tract. J Dig Dis. 2020;21(3):125-6. Citado en PubMed; PMID: 32096611.
26. Di Renzo L, Merra G, Esposito E, et al. Are probiotics effective adjuvant therapeutic choice in patients with COVID-19? Eur Rev Med Pharmacol Sci. 2020;24(8):4062-3. DOI: 10.26355/eurrev_202004_20977.
27. Biliński J, Winter K, Jasiński M, et al. Rapid resolution of COVID-19 after faecal microbiota transplantation. Gut [Internet]. 2022 [citado 02/05/2022];71(1):230-2. Disponible en: https://gut.bmj.com/content/71/1/230?fbclid=IwAR38LOPiG_yGb7GstGu_Ar3guAsjOuzuqBnGhE_5lam8sJtqECOEdcZA1GQ
28. Liu F, Ye S, Zhu X, et al. Gastrointestinal disturbance and effect of fecal microbiota transplantation in discharged COVID-19 patients. J Med Case Reports [Internet]. 2021 [citado 12/10/2021];15(60). Disponible en: https://doi.org/10.1186/s13256-020-02583-7
29. Samada Suárez M, Chao González L. Enfermedad inflamatoria intestinal y la COVID 19. Boletín Científico del Cimeq [Internet]. 2020 [citado 25/04/2021];1(11):4-5. Disponible en: https://instituciones.sld.cu/bolcimeq/2020/06/01/enfermedad-inflamatoria-intestinal-y-la-covid-19/
30. Hisamatsu T. Management of inflammatory bowel disease during the COVID-19 pandemic. Immunol Med [Internet]. 2021 [citado 12/10/2021];45(3):128-35. Disponible en: https://www.tandfonline.com/doi/full/10.1080/25785826.2021.1978205
Downloads
Published
2023-05-19
How to Cite
1.
Hernández-Ortega A, Ávalos-García R, Umpiérrez-García I. Diarrhea in patients with COVID-19 and pos-COVID syndrome. Rev Méd Electrón [Internet]. 2023 May 19 [cited 2025 Jan. 24];45(3):e4832. Available from: https://revmedicaelectronica.sld.cu/index.php/rme/article/view/4832
Issue
Section
Review article
License
All content published in this journal is Open Access, distributed under the terms of the CC BY-NC 4.0 License.
It allows:
- Copy and redistribute published material in any medium or format.
- Adapt the content.
This will be done under the following terms:
- Attribute the authors' credits and indicate whether changes were made, in which case it must be in a reasonable way.
- Non-commercial use.
- Recognize the journal where it is published.
The copyrights of each article are maintained, without restrictions.
Guidelines to authors
