Gastrointestinal Symptoms in Patients with COVID-19 and Usefulness of Stool Test

ABSTRACT

Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a global pandemic and is now the most threatening public health issue. Patients with the infection present with high fever and pneumonia with respiratory symptoms, but some patients also develop digestive symptoms such as diarrhea, vomiting, and abdominal pain. This may be the basis for the transmission route of the new virus, not only for respiratory infection through droplets but also for fecal-to-oral transmission. In addition, the high expression level of angiotensin-converting enzyme 2 on the surface cells in the gastrointestinal tract may support the occurrence of digestive symptoms and the possibility of fecal-to-oral transmission. Recent studies have shown positive fecal polymerase chain reaction (PCR) test results in patients with the infection who showed digestive symptoms. Therefore, we reviewed the related literature on the occurrence of digestive symptoms in patients with COVID-19 and present the usefulness and clinical application of the fecal PCR test for identifying the potential infection route and criteria for isolation.