{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:46:03Z","timestamp":1789595163655,"version":"build-2803163510"},"reference-count":151,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Coronavirus disease 2019 (COVID-19), a respiratory viral infection, has affected more than 78 million individuals worldwide as of the end of December 2020. Previous studies reported that severe acute respiratory syndrome coronavirus 1 and Middle East respiratory syndrome\u2013related coronavirus infections may affect the gastrointestinal (GI) system. In this review we outline the important GI manifestations of COVID-19 and discuss the possible underlying pathophysiological mechanisms and their diagnosis and management. GI manifestations are reported in 11.4\u201361.1% of individuals with COVID-19, with variable onset and severity. The majority of COVID-19-associated GI symptoms are mild and self-limiting and include anorexia, diarrhoea, nausea, vomiting and abdominal pain\/discomfort. A minority of patients present with an acute abdomen with aetiologies such as acute pancreatitis, acute appendicitis, intestinal obstruction, bowel ischaemia, haemoperitoneum or abdominal compartment syndrome. Severe acute respiratory syndrome coronavirus 2 RNA has been found in biopsies from all parts of the alimentary canal. Involvement of the GI tract may be due to direct viral injury and\/or an inflammatory immune response and may lead to malabsorption, an imbalance in intestinal secretions and gut mucosal integrity and activation of the enteric nervous system. Supportive and symptomatic care is the mainstay of therapy. However, a minority may require surgical or endoscopic treatment for acute abdomen and GI bleeding.<\/jats:p>","DOI":"10.1093\/trstmh\/trab042","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T04:32:09Z","timestamp":1613709129000},"page":"1362-1388","source":"Crossref","is-referenced-by-count":109,"title":["Gastrointestinal manifestations in COVID-19"],"prefix":"10.1093","volume":"115","author":[{"given":"Jayani C","family":"Kariyawasam","sequence":"first","affiliation":[{"name":"Institute of Biochemistry, Molecular Biology and Biotechnology, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0398-5197","authenticated-orcid":false,"given":"Umesh","family":"Jayarajah","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishdha","family":"Riza","sequence":"additional","affiliation":[{"name":"Colombo South Teaching Hospital, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Visula","family":"Abeysuriya","sequence":"additional","affiliation":[{"name":"Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-5673","authenticated-orcid":false,"given":"Suranjith L","family":"Seneviratne","sequence":"additional","affiliation":[{"name":"Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"2021120506553776600_bib1","volume-title":"Coronavirus disease (COVID-2019) situation reports","author":"Word Health Organization","year":"2020"},{"issue":"2","key":"2021120506553776600_bib2","doi-asserted-by":"crossref","first-page":"120","DOI":"10.4038\/jccp.v51i2.7906","article-title":"COVID-19 vaccine landscape","volume":"51","author":"Seneviratne","year":"2020","journal-title":"J Ceylon Coll Physicians"},{"issue":"2","key":"2021120506553776600_bib3","doi-asserted-by":"crossref","first-page":"330","DOI":"10.2307\/1588476","article-title":"Coronaviruses, a new group of animal RNA viruses","volume":"14","author":"Estola","year":"1970","journal-title":"Avian Dis"},{"issue":"11 Suppl","key":"2021120506553776600_bib4","doi-asserted-by":"crossref","first-page":"S223","DOI":"10.1097\/01.inf.0000188166.17324.60","article-title":"History and recent advances in coronavirus discovery","volume":"24","author":"Kahn","year":"2005","journal-title":"Pediatr Infect Dis J"},{"key":"2021120506553776600_bib5","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/bs.aivir.2018.01.001","article-title":"Hosts and sources of endemic human coronaviruses","volume":"100","author":"Corman","year":"2018","journal-title":"Adv Virus Res"},{"key":"2021120506553776600_bib6","first-page":"1","volume-title":"Coronaviruses: an overview of their replication and pathogenesis","author":"Fehr","year":"2015"},{"key":"2021120506553776600_bib7","first-page":"67","volume-title":"Healthcare-associated atypical pneumonia. 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